Quarterly scientific journal

The evolution of Greek primary healthcare from the implementation of the national healthcare system until today-The declaration of Astana and current challenges in primary healthcare

Vasiliki Tsigkou , Ioannis Apostolakis , Pavlos Sarafis



The declaration of Alma Ata in 1978 aimed at “Health for All by 2000” through the development of primary healthcare for the prevention, treatment and rehabilitation from the disease and the abolition of social inequities. Nevertheless, primary healthcare in Greece has never been able to reach this goal.

Greek primary healthcare has continuously been fragmented, without proper management and control, with poor management of human resources, lack of infrastructure, poor quality, high cost of services and focus on treatment than prevention. Several strategies have aimed at the reform of primary healthcare from the establishment of national healthcare system until 2009. However, a pilot test of the family doctor and referral system is under evaluation since 2017.

The declaration of Astana in 2018 pointed again the need for primary healthcare reform globally towards sustainable development. Greece has made some progress after several decades of unsuccessful reforms of primary healthcare; nevertheless, the whole strategy is yet under evaluation.

Keywords: Primary healthcare, declaration of Alma Ata, declaration of Astana, healthcare services

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