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Primary Health Care Conference |12 July 2019

Primary Health Care Conference

Guests and delegates in a souvenir photograph after the opening ceremony

Seychelles reflects on weaknesses, strengths of its Primary Health Care


Seychelles considers primary health care as the main focus of the health system. The Constitution guarantees free primary health care (PHC) in state institutions for all citizens. Many critical programmes and services are considered as being the bedrock of Seychelles’ PHC model.

In order to reflect on the strengths and weaknesses of the PHC in Seychelles, a three-day conference is ongoing at the AVANI Seychelles Barbarons Resort & Spa.

The main objective of this conference, in the light of the evolving society, is to reflect on the PHC with a view to respond to new and emerging challenges, safeguard the gains of yesteryear and address the priority unmet needs.

Various stakeholders, including the Minister for Health, Jean-Paul Adam; the Minister for Family Affairs, Mitcy Larue; the Speaker of the National Assembly, Nicholas Prea; the leader of government business in the National Assembly, Charles de Commarmond; other members of the National Assembly and of the health sector gathered for that conference.

“There is a tendency when addressing issues around health care, whether in Seychelles or anywhere in the world, to lament on just how challenging the situation is. We all fear that we cannot address the scale and scope of the need. The interesting thing is that this sentiment is often also a characteristic of the most advanced health systems. Because no matter how many resources you place in health, nor how well your system is organised, there is no end point to the need. Health is all encompassing. It is not just the absence of illness – it is the well-being of a people. As such it is interconnected with all aspects of our lives,” noted Minister Adam.

He further stated that PHC is the point at which we can however make the most impact towards addressing this ever-growing need, and also where we can be most effective in terms of our interventions.

“In our discussions we want to engage on ways in which we can redefine bringing health for all, bringing health everywhere in our country and health by all of our citizens. We are finding all possible ways to provide health for all, health everywhere and health by all of us!”

The minister asserted that “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 allow 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”.

The World Health Organisation’s (WHO) representative, Dr Teniin Gakuruh, qualifies Seychelles as being “among the few countries with a functional health system. In 1978 world leaders, international organisations and health authorities gathered in Alma-Ata (now Almaty, Kazakhstan) and released the Declaration of Alma-Ata on PHC which remains a landmark document in the history of global health. 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”.

She also said that the delivery of effective population-based services requires a public health workforce that is purposefully trained and necessary competence to carry out essential public health functions, such as surveillance, monitoring, preparedness and response, as well as deliver population-based services in health protection and promotion and disease prevention. Engaging the community in assessing the quality of health care has resulted in increased patient safety and reduced risk. The involvement of empowered people and communities as co-developers of services improves cultural sensitivity and increases patient satisfaction, ultimately increasing use and improving health outcomes.

She further noted that the regional director through transformation agenda has emphasised the need to enhance technical cooperation for all 47 countries in the region regardless of their economic status or health status to ensure no one is left behind. It is in this regard that the Seychelles Country Office is being elevated to a full fledged office while ensuring greater technical support by regional/sub-regional offices to ensure the country receives requisite support for all priorities to achieve sustainable development goals.

On the first day of the conference yesterday, Dr Bernard Valentin made a detailed presentation on the ‘Evolution of Primary Health Care in Seychelles’; Dr Jude Gédéon talked about the Seychelles Double Burden of diseases; UniSey student Wilnette Joseph talked about ‘My Health, my responsibility’ from the Youth Perspective (read the full presentation on page 7); Rhonda Burka talked about ‘What does the ‘Care’ in Primary Health Care really mean?’; Dr Gertrude Avorti and Dr Tarcisse Elongo spoke about the global perspectives on PHC (WHO); Dr Sanjeev Pugazhendhi spoke about Selected Good practices in Primary Health Care; Yogendranath Ramful gave the Mauritian experience in implementing PHC and there was a panel discussion on the topics already presented.

The conference was chaired by Dr Conrad Shamlaye.

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