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# Primary health care in Colombia

- System and programme

PHC is the strategy that brings the health system close to people: teams in the territory, prevention, work with other sectors and community participation.

Updated Nov 13, 2026

## Key points

- Alma-Ata, 1978: health is a fundamental human right, inequalities are unacceptable and PHC is the key to Health for All.
- Astana, 2018: renews the commitment to PHC as the basis of universal health coverage and the Sustainable Development Goals.
- Law 1438 of 2011, article 12: PHC has three integrated, interdependent components: health services, intersectoral action, and social, community and citizen participation.
- PHC spans public health, promotion, prevention, diagnosis, treatment and rehabilitation at every level of complexity: it is not just ‘the first level’.
- Law 1438, articles 15 and 16: basic health teams carry out family assessment, identify risks, promote enrolment and drive demand for services.
- PHC principles in Law 1438 include universality, interculturality, equality and a differential approach, comprehensive care, intersectoral action, participation and a territorial approach.

On this page

- The basics Key points
- What it is
- How it is organised
- Worked example
- PHC, from global to national
- Markers
- In practice
- Reference norms
- Memory aid

- Study Test yourself

- Connections Connections

## What it is

Primary health care (PHC) became a global strategy with the Declaration of Alma-Ata (1978), which named it the key to reaching ‘Health for All’, and was renewed by the Declaration of Astana (2018), which presents it as the most effective route to universal health coverage. In Colombia, Law 1438 of 2011 adopted PHC as the strategy of the health system, with three integrated components: health services, intersectoral action and social participation. Later care models have been built on it.

## How it is organised

- Health services: comprehensive, integrated and continuous care, with emphasis on promotion and prevention and a strengthened low-complexity level able to resolve the most common needs.
- Intersectoral action: work with education, water and sanitation, housing, labour and other sectors to act on the determinants of health.
- Social participation: the community takes part in planning, delivering and overseeing actions.
- Basic health teams: a functional unit organised by the territory to ease access, adapted to the needs of the population.

## Worked example

- A made-up basic health team covers a rural area with 400 families.
- In three months it visits 300 families: assessment coverage = 300 / 400 = 75%.
- It finds 12 pregnant women; 5 had no antenatal care: 5 / 12 ≈ 42% (rounded).
- Of 90 children under 5, 18 have incomplete vaccination: 18 / 90 = 20%.
- It refers those 23 people (5 pregnant women and 18 children) to the clinic and organises a school vaccination day with the mayor's office.
- Reading: the home visit turns into risk data and action; the 100 families still unvisited are next quarter's target.

## PHC, from global to national

| Milestone | Year | Core idea |
| --- | --- | --- |
| Declaration of Alma-Ata | 1978 | PHC as the key to Health for All |
| Law 1438 | 2011 | PHC as the strategy of the SGSSS, with three components and basic teams |
| Declaration of Astana | 2018 | PHC as the route to universal coverage and the SDGs |
| Decree 858 | 2025 | Preventive, predictive and resolutive health model founded on PHC (provisionally suspended in October 2025) |

## Markers

- PHC
- Alma-Ata 1978
- Astana 2018
- Basic health teams
- Law 1438 of 2011

## In practice

- A basic team visits families in a rural district, fills in the family form, detects risks (a pregnant woman without check-ups, an unvaccinated child) and refers them to services.
- Individual care follows the integrated care pathways (RIAS); collective actions are funded by the Collective Interventions Plan; PHC links both.
- The PHC doctor provides continuity: knows the family, coordinates referrals and receives the counter-referral.

## Reference norms

- Law 1438 of 2011, articles 12 to 16: adopts the PHC strategy, its principles, the strengthening of low-complexity care and basic health teams.
- Declaration of Alma-Ata (1978) and Declaration of Astana (2018): WHO's international framework.
- Decree 858 of 2025: adopted the Preventive, Predictive and Resolutive Health Model founded on PHC; the Supersalud legal database shows it provisionally suspended by the Council of State (order of 21 October 2025).

## Memory aid

Three legs hold up the PHC stool: services, sectors and community; take one away and it tips over.

## Test yourself

Think of the answer, then tap the question to see it.

## Which 1978 declaration named PHC as the key to Health for All?

The Declaration of Alma-Ata, adopted at the International Conference on Primary Health Care.

## What are the three components of PHC under Law 1438 of 2011?

Health services, intersectoral action for health, and social, community and citizen participation.

## What do basic health teams do under Law 1438?

Family assessment, identification of individual, family and community risks, promotion of enrolment, demand generation and information for the medical record.

## Is PHC the same as the first level of care?

No. It is a strategy that integrates public health, promotion, prevention, diagnosis, treatment and rehabilitation at all levels; the first level is its entry point.

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## Connections

## Related 6

- [Care models: PAIS, MIAS and MAITE](https://durgical.com/en/epidemiology/care-models-pais-mias-and-maite/)
- [The Collective Interventions Plan (PIC)](https://durgical.com/en/epidemiology/the-collective-interventions-plan/)
- [Comprehensive health care pathways (RIAS)](https://durgical.com/en/epidemiology/comprehensive-health-care-pathways/)
- [Social determinants of health](https://durgical.com/en/epidemiology/social-determinants-of-health/)
- [Levels of prevention](https://durgical.com/en/epidemiology/levels-of-prevention/)
- [Colombia's General System of Social Security in Health (SGSSS)](https://durgical.com/en/epidemiology/colombia-s-general-system-of-social-security-in-health/)

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Educational content on epidemiological and statistical methods; the examples use made-up numbers to teach the calculation. Not a clinical or legal guide: current Colombian rules are in the official sources.

Sources: [WHO called to return to the Declaration of Alma-Ata](https://www.who.int/teams/social-determinants-of-health/declaration-of-alma-ata) (World Health Organization, 2026); [Declaration on Primary Health Care](https://www.who.int/teams/primary-health-care/conference/declaration) (World Health Organization, 2018); [Ley 1438 de 2011](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=41355) (Departamento Administrativo de la Función Pública, Colombia (Gestor Normativo), 2011); [Compilación Jurídica SuperSalud - Decreto 858 de 2025](https://normograma.supersalud.gov.co/compilacion/docs/decreto_0858_2025.htm) (Superintendencia Nacional de Salud, Colombia, 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/epidemiology/primary-health-care-in-colombia/