MÁLAGA, 11 Apr. (EUROPA PRESS) -

The Andalusian Association of Family and Community Nursing (Asanec) has maintained this Thursday the need for "a comprehensive transformation of Primary Care in the face of the risk of losing equity in health and of not being able to provide an effective response to the demands and challenges, both current and future, in public health".

Asanec, on the occasion of the International Primary Care Day, which is celebrated on April 12, has warned that "without political will and commitment on the part of the institutions there are no options for PC" and have highlighted that family nurses and community organizations "can and want" to offer effective solutions to many health challenges in society, but "the current conditions and context make it increasingly unfeasible."

The Andalusian Association of Family and Community Nursing has explained that "the impact of Primary Care on global health is a fact that is hardly debatable, widely based on multiple studies over the last thirty years, especially in the attenuation of inequalities in health and in reducing mortality from all causes".

The World Health Organization (WHO) defines Primary Care as "a society-wide approach to health that aims to ensure the highest possible level of health and well-being." "PA must be equitably distributed by focusing care on people's needs as early as possible and along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as possible to people's daily environment.

"It is paradoxical that National and Regional Strategies have been developed - such as the AP 21 Strategy at the beginning of the century, until the most recent Strategic Framework for Primary and Community Care 2022-23 - and, meanwhile, the percentage of public health spending dedicated to Primary Care has decreased by 4.2 percent in the period 2002-2021 - with large inter-autonomous differences -, or that human resources are in permanent crisis and underfunded," Asanec has indicated.

According to the vice dean of Research and Postgraduate Studies and coordinator of the Doctoral Program in Health Sciences at the University of Malaga, the professor and researcher of the Department of Nursing, José Miguel Morales, "the great reserve of solutions for current health challenges is in the hands of a strengthened Primary Care".

In particular, "nurse specialists in this environment are one of the great alternatives to transition to care models that promote accessibility and continuity of care with health impacts demonstrated in a multitude of scientific studies." "Health ministries have in their hands a great opportunity to promote effective solutions, focusing on enhancing and supporting the vital work carried out by Family and Community Nursing professionals in the comprehensive care of people and communities," said Morales. .

However, in the specific case of Andalusia, despite the incorporation of family and community nurses in recent years; such as child and adolescent nurses or school reference nurses, "the ratio of Andalusian Primary Care nurses per inhabitants in 2022 was 0.68 professionals per 1,000 inhabitants, lower than the national global average of 0.70 and is at 0 .21 points away from the Community with the best rate and far from the approximately three nurses per 1,000 inhabitants in Primary Care in Europe, according to data from the WHO European Region Office," the expert emphasized.

For Morales, "this scenario hardly complies with WHO resolution WHA 74.14, which urges Member States to continue the Global Strategy for Human Resources for Health 2030, which invites them to advance the investment agenda in health human resources with special focus on Primary Care". In this way, he stressed that, "this downward inertia cannot continue any longer and an urgent change is necessary." "Health is a fundamental human right and strengthening Primary Care, with the support and leadership of family and community nurses, is essential to guarantee that this right is fulfilled for all people, regardless of their economic or social condition."

"It is time to act with determination and commitment to transform Primary Care and build a healthier and more equitable future for all," the association has stated.

Asanec has indicated that, "Primary Care in our country needs urgent reinforcement in terms of investment to be able to align reality with the recommendations of international organizations and evidence." "Our decision-makers cannot continue looking the other way while Primary Care faces a precipice that leads to its denaturalization and loss of capacity to guarantee equity and accessibility."

"Family and community nurses are willing to give our all for population health, but we need health institutions and organizations to react once and for all with seriousness and commitment," concluded the Andalusian Association of Family and Community Nursing. .

Asanec recalled that, for more than three decades, the WHO has been establishing strategies and priorities aimed at placing Primary Care as the axis on which to guide all attention to the health of the population.

There have been multiple resolutions, --the last in 2019, WHA 72.2-- and Declarations --the last, the Astana Declaration of 2018--, urging Member States to "ensure solid Primary Care that includes the participation of all government and society bodies combining three essential components: multisectoral policies and measures; the capacity for action and decision of people and communities; and integrated health services focused on primary care and essential public health functions." .

For Asanec and coinciding with the WHO, this reinforcement must materialize in four basic strategies, "political commitment, development of policies and regulations in favor of Primary Care, adequate financing and participation of communities to identify problems and define priorities."

As they have argued, these four coordinates must be operationalized, among other actions, through effective care models, "reinforcing human resources and infrastructure, systems to improve the quality of care, the incorporation of digital technologies that facilitate accessibility or research in Primary Care".

These mechanisms proposed by the WHO are based on "empirical data and experience obtained during years of implementing health system reforms. However, the reality is discouraging," family and community nurses have pointed out. Asanec has concluded by indicating that, "Primary Care in our country needs urgent reinforcement in terms of investment to be able to align reality with the recommendations of international organizations and evidence."

"Our decision-makers cannot continue looking the other way while Primary Care faces a precipice that leads to its denaturalization and loss of capacity to guarantee equity and accessibility." "Family and community nurses are willing to give our all for population health, but we need the political class to react once and for all with seriousness and commitment."