In Seychelles, every Seychellois is entitled to basic health care as enshrined in its Constitution. In the early 1980s, the country adopted the primary health care approach, where all Seychellois, irrespective of their living circumstances, receives primary health services free of charge at the point of use in the public sector. Close to forty years down the line, with the technical support of the World Health Organisation (WHO), the Ministry of Health (MoH) held a national conference to take stock of the country’s primary health care system. The PHC Conference brought together a diverse group of stakeholders from policy makers, regulators, health professionals in the public and private sectors as well as community groups.

At the opening of the three-day conference, which was also graced with the presence of a number of Ministers, the Speaker of the National Assembly and other Parliamentarians, the Minister of Health Honorable Jean-Paul Adam stated that PHC is the point where most impact towards addressing new and emerging challenges can be made and where interventions can be most effective. He simplified “Health-for-all, health-in-all and health-by-all” as a key concept underlying PHC.

“In Seychelles, when we say: “Health for all”, we are expressing determination that every citizen shall have equal access to the best quality of life that our society can provide. We are committing to give our citizens access to health services that allows them to live fulfilling lives. 

When we are saying Health everywhere, we are underlining that our health centres are only one part of the chain of good health.  We must also bring the conversation about health to everywhere where people live, work and play.  
And when we are saying health by all, we are saying that health is a shared responsibility that we must all contribute to be able to achieve. Our health is our responsibility”, said Minister Adam. 

The Minister also urged the participants to take the opportunity to be provided by the conference to identify the various successes of the primary health care approach since its adoption in Seychelles decades ago, but to also discuss whether the system still meet the needs, expectations and emerging health challenges of today. 

In her address, the WHO Representative for Seychelles, Dr. Teniin Gakuruh commended the government for the achievements reached so far despite the challenges. 
“The world, including Seychelles, has made excellent progress on global health, with changes so great that life expectancy is now around 10 years more that in 1978, and the risk of dying before the age of 5 years has fallen by around two thirds. Indeed the spectrum of disease is now very different from 40 years ago, due to the demographic and epidemiologic transitions that have occurred. The progress and challenges of the 21st century justified the review of the Alma-Ata Declaration which occurred in 2018 in Astana”.

Various sessions were addressed during the three days discussions, ranging from reflections on primary health care practices in Seychelles, identification of any unmet health needs of the population and new strategies to explore with regards to health governance, leadership, planning, monitoring and evaluation and health promotion. How to further build partnerships and engagement of sectors outside of health, and the strengthening of PHC in private practice were also intensively discussed. Dr. Tarcisse Elongo and Dr. Gertrude Avorti from the WHO Regional Office for Africa also participated in the conference, providing the global perspectives on PHC.

At the end of the Conference, a number of resolutions aimed at addressing identified weaknesses in PHC in Seychelles were approved. Key resolutions include calling on the Ministry of Health and its partners to maintain and strengthen the country’s health gains, to invest more resources on disease prevention and health promotion and to modernise PHC policies and programmes. Another resolution calls on the achievement of a consensus on a Seychelles Charter for Health and the relevant mechanisms for its implementation. In addition, a further resolution calls for the commitment of all stakeholders to move PHC forward in line with the recent Astana declaration.  
     
In 1978, world leaders and international organisations agreed on the Declaration of Alma-Ata on PHC which identified PHC as key to the attainment of the goal of Health for All. The Declaration reaffirmed health as a human right, and identified the strengthening of PHC as a ‘cornerstone’ of global health policy. In 2018, the Astana Declaration, again emphasized the critical role of PHC around the world and urged all stakeholders to refocus efforts to ensure that everyone, everywhere is able to enjoy the highest possible attainable standard of health. This is believed to be the key to successfully achieve the shared global goals in universal health coverage and the health-related Sustainable Development Goals (SDGs).
 
As the UN specialized agency on health, WHO remains dedicated to support countries including the Seychelles to develop the strongest health system in order to achieve universal health coverage and the health related SDGs. Henceforth, the WHO Country Office will work with the Ministry of Health to address the approved resolutions with the aim of delivering better health outcomes, efficiency and improved quality of care for the people of Seychelles.