ReviewBMJ global health2019
After the Astana declaration: is comprehensive primary health care set for success this time?
Review in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Opportunities, challenges, and requirements for Artificial Intelligence (AI) implementation in Primary Health Care (PHC): a systematic review.BMC primary care · 2025Pooled it
- Performance measurement systems in primary health care: a systematic literature review.BMC health services research · 2025Pooled it
- Australian Community Health and Primary Health Care Policies from 1970s to 2020s: A Policy Analysis of Changing Interpretations.International journal of social determinants of health and health services · 2026Article
- Understanding the role and organization of health workers delivering non-communicable disease management in primary care in low- and middle-income countries: a scoping review.BMC primary care · 2025Article
- Synthesising key findings from Indonesia's first civil society-led forum on primary health care: PHC forum, Jakarta, 13-14 November 2023.BMC proceedings · 2025Article
- Role of a primary healthcare approach in COVID-19 pandemic response in the eastern Mediterranean region: multicountry case study synthesis.BMJ global health · 2025Article
- Conceptually mapping how investing in essential public health functions (EPHFs) and common goods for health (CGH) can improve health system performance.Frontiers in public health · 2025Article
- Strengthening primary health care in Ethiopia: A scoping review of successes, challenges, and pathways towards universal health coverage using the WHO monitoring framework.PLOS global public health · 2025Article
- Health system and policy response to climate change in the West Bank, Palestine: Current situation and priority actions.PLOS global public health · 2025Article
- Strategies for improving the financing of family medicine program: Evidence from Iran.Health science reports · 2024Article
- Prevalence of unmet health care need in older adults in 83 countries: measuring progressing towards universal health coverage in the context of global population ageing.Population health metrics · 2023Article
- Making districts functional for universal health coverage attainment: lessons from Ghana.Frontiers in public health · 2023Article
- Beyond Astana: Configuring the World Health Organization Collaborating Centres for primary health care.PLOS global public health · 2023Article
- Global Health Strategies in the Face of the COVID-19 Pandemic and Other Unprecedented Threats.Journal of Korean medical science · 2022Review
- The sustainable health Agenda in the Americas: Pre-pandemic gaps and 2030 estimates of the SDGs indicators.PloS one · 2022Article
- Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review.BMJ open · 2021Article
- Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context.Health policy and planning · 2021Article
- Strength in Diversity: Integrating Community in Primary Health Care to Advance Universal Health Coverage.Global health, science and practice · 2021Article
- Advancing community health measurement, policy, and practice.Journal of global health · 2021Article
- Towards universal health coverage in the WHO African Region: assessing health system functionality, incorporating lessons from COVID-19.BMJ global health · 2021Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Primary health care (PHC) strengthening in order to achieve the Sustainable Development Goal has again, 40 years after the Alma-Ata declaration, been declared a priority by the global health community. Despite initial progress the Alma-Ata vision of Health for All by the year 2000 was not realised. In this analysis we (1) examine the challenges that comprehensive PHC faced after the Alma-Ata declaration, (2) provide an analysis of the current opportunities and threats to comprehensive PHC strengthening on the global, national and community level and (3) review the most important policy recommendations and related evidence to address these threats for success of the Astana declaration. Factors that are predominantly opportunities are the treasure of historical lessons from the past 40 years, the increased attention to social and environmental determinants of health, the global economic growth and new technologies, in particular digital medicine, which also have the potential to revolutionise community involvement. Factors that are currently predominantly threats are insecurity, conflicts and disease outbreaks; lack of sustained political commitment and inappropriate monitoring and evaluation structures; inappropriate and unsustainable financing models; insufficient health workforce recruitment, employment and retention; missing support of physicians and their professional organisations; inadequately addressing the needs of the community and not giving attention to gender equity. In contrast to the policy and evidence context in 1978 when Alma-Ata was passed there are today policy recommendations and a large body of evidence that can address the threats to comprehensive PHC-and turn them into opportunities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.