The Alma-Ata Declaration (1978) defined Primary Health Care (PHC). The Astana Declaration (2018) built on Alma-Ata. What is the CORE addition of the Astana Declaration compared to Alma-Ata regarding PHC?
- A It introduced the concept of universal health coverage (UHC) as an explicit global target linked to PHC and emphasized multisectoral action and empowered communities ✓
- B It replaced the concept of selective PHC with comprehensive PHC
- C It mandated free essential medicines in all primary care settings
- D It created the Sustainable Development Goals (SDGs) framework
Correct answer: A. It introduced the concept of universal health coverage (UHC) as an explicit global target linked to PHC and emphasized multisectoral action and empowered communities
Explanation
The Astana Declaration on PHC (2018), issued at the WHO Global Conference on PHC, reaffirmed Alma-Ata's comprehensive PHC principles and explicitly linked PHC to Universal Health Coverage (UHC) and the SDGs. Its new emphases include: knowledge and capacity of individuals and communities, multisectoral policy coherence, primary health care as the foundation of UHC, and addressing determinants of health. Selective PHC (GOBI-FFF) was a post-Alma-Ata compromise by UNICEF/World Bank, not replaced by Astana. SDGs were defined by the UN in 2015, not by Astana.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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