Abstract
For centuries, health was viewed from the lens of biomedicine as the core. This view considered medical professionals and hospitals as the sole agents and venues where health could be obtained, with only passive mentions of the impact of social determinants of health. In a paradigm shift from this view in 1978, at the Alma-Ata Declaration in Kazakhstan, 134 member countries of the WHO formalized the recognition of the social determinants of health into a global policy. Factors such as accessibility, affordability, availability, social and economic status, and education about health services are crucial for population health. The Alma-Ata Declaration required the governments of member countries to include deliberate policies that strengthen and promote population health, by ensuring that social measures are included in their national development plans while recognizing the rights of collective and individual participation of their populations. The phrase “Primary Health Care” (PHC) was then adopted. It was defined as “essential health care based on practical, scientifically sound and socially acceptable methods which are of relevant technology, made accessible and affordable to families and communities through their participation”. Health became a human right underpinned by equity and population participation principles. The aftermath of the Declaration was an immediate implementation challenge. It was soon to be realized that PHC interventions are not linear and generalizable like biomedical interventions which have specific measures and predictable outcomes. To date, there is no blueprint for universal intervention measures because economic disparities, social and situational contexts differ and determine the success of any intervention measure. Our review explores the challenges and successes of the implementation of PHC in Kazakhstan, the birthplace of the global health policy on PHC.