Baltic States – CIS, Estonia, EU – CIS, Forum, Medicine

The summit marks 40 years since the Declaration of Alma-Ata, which was the first international declaration underlining the importance of primary healthcare. The last general practice reform in Estonia took place 27 years ago. 

The summit in Astana is focused on the role of primary healthcare in achieving universal health coverage and the UN Sustainable Development Goals set for 2030. The official delegation of Estonia includes Minister of Health and Labor Riina Sikkut, member of the board of the Estonian Association of General Practitioners Dr Karmen Joller, vice-president of the Estonian Nurses Association Gerli Liivet and member of the board of the Estonian Health Insurance Fund Pille Banhard.

The Estonian minister of health and labor said that in 25 years, a well-functioning system of family doctors has been established, and that the soon-to-be created health centers, family doctors' teams will improve and a larger variety of services will be provided. 

Dr Joller said that the Declaration of Alma-Ata expressed for the first time the principle of primary healthcare -- in medicine, everyone needs to have a guide. "Today, 40 years later, the summit focuses on improving and updating the declaration. The family doctors' system in Estonia has set an example for many states -- each person has a family doctor who is their guide in tackling their health problems," she added that in their daily work, family doctors are guided by the declaration's principles that primary healthcare needs to be of high quality, patient-centered and caring.

The number of family doctors with a practice list is 788 in Estonia. Funding for primary healthcare grew by 10% in the first six months of 2018 compared to the same period in the previous year. Based on the data of 2016, the average Estonian visited their family doctor 3.2 times and their nursing staff 1.6 times per year. Visits to nursing staff increased by 16% in 2016, while a third of these visits were made to see the family nurse.

Based on a survey by pollster Kantar Emor in 2016, Estonians hold primary health care in high regard. Approximately 80% of the respondents were satisfied with their family doctor as well as the family doctor system. By 2023, at least 55 modern primary healthcare centers will be built in Estonia, funded by the the European Regional Development Fund. At the new health centers, in addition to general practitioners and family nurses, the services of a physiotherapist, home nurse and midwife will be available, as well as other specialists.

The Declaration of Alma-Ata emphasized that primary healthcare must become the basis for health systems, which must be equally accessible to all. Forty years later, the plan at the Astana summit is to adopt a new global declaration, which will affirm the key role of primary healthcare in ensuring the sustainability of the health system and the continued commitment to developing primary medical care.

The summit is organized by the Ministry of Health of Kazakhstan, World Health Organization and UNICEF.