Is primary health care progressing in Europe?

Primary health care (PHC) is the key to attaining the goal of health for all (HFA) by the year 2000. Also the European countries have accepted the declarations and WHO resolutions related to global and European HFA strategies. However, the implementation of regional and national strategies has met with many obstacles, caused by reluctant attitudes and poor planning and management systems. In this review the objective of PHC in industrialized countries, the evaluation process of HFA strategy, and progress in PHC in Europe in the 1980s are discussed. Lack of defined national objectives, and health information systems which are not adopted to purposes of monitoring progress in PHC are causing most of the problems in evaluation. There is a clear positive development in PHC resources and organization in the Nordic countries. Generally speaking PHC is progressing very slowly in Europe, if there is any progress at all. This can be said both about organization of health care, planning and management systems and about application of PHC principles like community participation and intersectoral collaboration. The national health information systems should be quickly revised to allow more exact monitoring of progress towards the 38 European targets and additional national targets.