Por Nancy Villagra Rivera enfernancy@hotmail.com
Fortalecer la Atención Primaria de la Salud (APS) fue la esencia de Conferencia Global de Atención Primaria en Salud celebrada el 25 y 26 de octubre en el 2018 y consignada en la Declaración de Astaná. En el encuentro, realizado en la ciudad de Kazajstán, en el centro de Asia, los países reafirmaron el compromiso declarado en Alma-Ata en 1978. Esta nueva responsabilidad se enfoca en las siguientes acciones:
Las naciones miembros de OMS, reafirman su compromiso con el derecho fundamental de todo ser humano a gozar de salud en un marco de justicia y solidaridad. Además la importancia de la paz, la seguridad y el desarrollo socioeconómico de las naciones.
Promulga, que el fortalecimiento de la atención primaria de la salud es el enfoque más inclusivo, eficaz y efectivo para la mejora de la salud física y mental de las personas. Así también, la Atención Primaria de la Salud sigue siendo la piedra angular de un sistema de salud sostenible para la cobertura sanitaria universal (CSU) y los Objetivos de Desarrollo Sostenible relacionados con la salud.
En tercer lugar, se declaran conscientes de que a pesar de los progresos logrados desde Alma Ata, aún persisten las necesidades de salud no satisfechas en el mundo. Esto da lugar a que mantenerse en buena salud continúa siendo un reto para personas vulnerables. En este sentido, expresan que es inaceptable que persistan las disparidades y la inequidad en salud. Se comprometen a combatir la creciente carga de enfermedades no transmisibles, que provocan mala salud y muertes prematuras debido al consumo de tabaco, el consumo nocivo de alcohol, los modos de vida y comportamientos poco saludables; así como también, a causa de las guerras, la violencia, las epidemias, los desastres naturales, los efectos del cambio climático, los fenómenos meteorológicos extremos y otros factores medioambientales. Para lograr este cometido, los servicios de promoción, prevención, curación, rehabilitación y la atención paliativa, deben ser accesibles a todos.
Se proponen erradicar la atención fragmentada, poco segura o de calidad deficiente. Así también, solucionar la escasez de trabajadores de la salud y su distribución desigual. En este punto destaca la preocupación por los costos de la atención y el despilfarro debido a la ineficiencia.
Para lograr hacer realidad estos importantes aspectos de la salud mundial, las naciones se comprometen a:
- Tomar decisiones políticas audaces en pro de la salud en todos los sectores
- Establecer una atención primaria de la salud que sea sostenible
- Empoderar a las personas y las comunidades
- Alinear el apoyo de las partes interesadas con las políticas, estrategias y planes nacionales.
La Declaración de Astaná fue firmada por los 193 países miembros de la Organización de las Naciones Unidas (ONU), comprometiéndose a reforzar sus sistemas de Atención Primaria de Salud como paso esencial para lograr la cobertura sanitaria universal.
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