The pain of the doctor is looking for: how Russia is modernizing primary healthcare
In Russia, work continues on the modernization of primary health care. The implementation of regional programs has been extended until 2030. Special attention will be paid to rural areas and stronghold settlements, because for their residents, the availability of primary care is not a matter of comfort, but of basic medical safety, experts say. How the primary healthcare sector is being modernized in Russia — in the Izvestia article.
The five-year plan
In Russia, the implementation of regional projects for the modernization of primary health care has been extended. The programs under the new national project "Long and active life" will be valid until 2030. The corresponding decree was signed by Prime Minister Mikhail Mishustin.
It follows from the document that the regions will have to include as a matter of priority in their programs for the modernization of primary health care activities that will affect the main settlements (small towns, villages and towns selected for priority infrastructure development). For the development of primary care in rural areas, urban-type settlements and small towns, the subjects of the federation will receive funding for the overhaul of medical institutions, the purchase of equipment and cars, as well as the purchase and installation of prefabricated modular structures to accommodate outpatient clinics and midwifery centers.
Funds under the program will also be allocated for the opening of vascular departments and cancer care centers (previously, this work was carried out within the framework of other federal projects).
In total, the federal budget provides more than 447 billion rubles for the development of primary health care until 2030.
Large-scale program
The medical system in Russia consists of three levels. Each of them is determined by the complexity of the clinical case and the competence of the staff. The primary level includes institutions that provide basic and specialized health care. These are polyclinics, outpatient clinics, women's clinics, paramedic and obstetric centers, general practitioners' offices, as well as day hospitals.
Primary health care is considered the most in demand: the number of referrals to polyclinics, hospitals, outpatient clinics and clinics exceeds 1.2 billion per year. About 80% of all clinical cases are resolved at this stage.
To improve medical care in Russia, work has been underway for several years to modernize primary health care. To this end, back in 2019, the government approved Resolution No. 1304, which formulated the basic principles of the modernization process.
Over the years, the program has allowed for major repairs of 5.5 thousand medical institutions, affecting almost every third healthcare facility. At the same time, the use of prefabricated modular structures made it possible to create about 5,000 new facilities, which purchased more than 200,000 units of medical equipment. In addition, the funds allocated under the program were used to purchase more than 18,000 passenger cars for the delivery of patients, doctors, biomaterials and medicines.
It is expected that by 2030, thanks to state support, it will be possible to purchase at least 9 thousand mobile medical complexes. In five years, at least 7 thousand buildings of medical organizations will be overhauled and equipped with the necessary equipment. This includes institutions located in rural areas, workers' settlements, urban-type settlements and small towns with a population of up to 100,000 people.
The editorial board of Izvestia sent a request to the Ministry of Health of the Russian Federation. No response has been received at the time of publication.
The situation in the regions
Active work on the modernization of primary health care is underway in all regions of the country. In St. Petersburg, for example, the program has been implemented since 2021 and is funded from the federal and city budgets, the city health committee explained to Izvestia. In 2025, 4.72 billion rubles were allocated for the program, which is almost a billion rubles more than a year earlier. Of this amount, 3.87 billion rubles were allocated for the purchase of 1,396 pieces of equipment, and 845 million rubles were allocated for the overhaul of 19 healthcare facilities. In total, 163 facilities have been repaired and 6053 pieces of equipment purchased under the program over 5 years.
"This has made it possible to significantly change the appearance of polyclinics, the conditions of care, equip them with modern equipment, and create bright and comfortable spaces with clear navigation," the department stressed.
Since 2021, a primary care modernization program has been implemented in the Republic of Khakassia. This was reported in the Ministry of Health of the region. The volume of resource provision for this subject of the Russian Federation, calculated for the period up to 2030, according to the agency, is more than 6 billion rubles. Of these, 5.6 billion rubles are from the federal budget, and 505.5 million rubles are from the republican budget.
The ministry reported that over the five years of the program, 2.5 billion rubles were spent on the implementation of its activities. This money was used, among other things, to build a children's polyclinic in the village of Askiz and to begin the construction of two children's polyclinics in Abakan and Chernogorsk. In addition, during the specified period, 24 prefabricated modular healthcare facilities were purchased and installed, 20 medical facilities were overhauled, and 220 units of medical equipment, including 7 units of "heavy" equipment, and 111 vehicles were purchased.
In the period from 2026 to 2030, the Ministry of Health of Khakassia plans to overhaul 12 healthcare facilities, build a polyclinic in the working village of Ust-Abakan, 26 prefabricated modular structures, including FAPs in the villages of Ius and Kirba and a 30-bed round-the-clock hospital in the village of Bograd.
In addition, the republican ministry expects to buy 38 more units of "heavy" medical equipment. The total amount of financing in all areas will amount to 3.6 billion rubles.
In the Saratov Region, 12 healthcare facilities have already been built and commissioned under the primary care modernization program from 2021 to 2025. Among them are polyclinics, an infectious diseases department and a women's consultation. Another 77 rooms were completely renovated. 74 new medical and obstetric stations equipped with medical equipment and furniture have been introduced in rural areas.
— As part of the regional program for the modernization of primary health care over the 5 years of the program's activities, it is planned to purchase 369 units of specialized motor transport and 6016 units of medical equipment. Of these, 146 units. "heavy" equipment: fluorographs — 41 units, stationary X—rays - 54 units, mammographs — 34 units, CT - 14 units, MRI — 3 units," the regional Ministry of Health added.
The Ministry of Health of the Novosibirsk Region noted that the implementation of the project in the region will develop in the areas of providing medical equipment and medical personnel to organizations providing primary health care. Construction and major repairs of healthcare facilities will continue. In particular, in the period up to 2030, polyclinic buildings will be erected in the cities of Karasuk, Berdsk and Tatarsk. In addition, the region plans to carry out major repairs of 6 healthcare facilities in rural strongholds.
—In 2026, 2028 and 2030, it is planned to purchase 17 units of "heavy" medical equipment - 14 fluorographs and 3 mammographs for medical organizations providing primary health care," the department added.
Investing in the future
Modernization of primary care is the foundation of an effective and sustainable healthcare system, according to the Ministry of Health of the Saratov region. About 70-80% of health problems should be solved at this level.
"A competent therapist or general practitioner can diagnose chronic diseases and cancer at an early stage in time, which radically reduces the cost of treatment and saves lives," the Ministry of Health of the region explains.
It is the primary link that is the first point of contact between a person and the healthcare system, notes Kirill Masliev, Candidate of Medical Sciences, member of the State Council Commission "Long and Active Life", Head of the Department of Preventive Medicine at RUDN University.
— The timely start of treatment and the development of preventive medicine directly depend on its availability and quality: early diagnosis of diseases, prevention of complications, — says the expert.
Timely detection of hypertension, diabetes, and initial forms of cancer dramatically changes the prognosis and reduces the cost of subsequent expensive treatment, which often falls on higher-level budgets, says Natalia Gavrilova, MD, Professor, Chief Physician of the Scandinavian Health Center.
For rural residents, the development of primary care is not only a matter of comfort, but also basic medical safety, says Masliev. The FAP or outpatient clinic for such people is often the only point of access to medical care, Gavrilova clarifies, emphasizing that people's lives directly depend on its equipment and personnel.
Masliev recalls that for a long time he had to go to Moscow and other major cities for high-quality medical care. For residents of the regions, this meant additional financial costs, and in some cases, lost time, which was crucial for treatment.
"The consistent modernization of primary care is aimed at breaking this logic and making modern medical care available at the place of residence," explains the Izvestia interlocutor.
An integrated approach is needed for the further development of primary care in Russia, he is convinced. It is important not only to build and renovate buildings, but also to introduce modern standards for the organization of patient admission, digital solutions and telemedicine, Masliyev lists.
According to the expert, the renewal of the fleet is also essential, especially in rural areas, where access to medical care is directly related to long distances.
— And, of course, no modernization is possible without taking care of the main resource — specialists. It is extremely important to ensure not only working conditions, but also opportunities for professional and career growth," the source is convinced.
The personnel shortage remains the most acute problem faced by the primary health care sector, Gavrilova confirms.
— Modern equipment is useless without doctors and mid-level medical staff. Comprehensive measures are needed to secure personnel in rural areas (housing, lifting, social packages, and continuing education opportunities). Without a parallel, proactive training and incentive program, investments in infrastructure can have low returns, warns the Izvestia interlocutor.
In general, the effectiveness of the program depends heavily on the competence and activity of the regional authorities. It is necessary to change the logistics of patients, routing, and the system of interaction with hospitals so that the modernization is tangible for the person, the doctor clarifies.
The modernization of primary healthcare is an investment in the health of the nation and the country's economy, the Saratov Ministry of Health emphasizes. Effective primary care reduces the number of hospital admissions, which reduces the burden on hospitals and ambulances.
— Without high-quality and affordable primary care, the healthcare system is doomed to "patch holes." Problems at this level are fraught with overcrowded hospitals, burnt-out ambulances, rising healthcare costs and citizens' discontent. Strengthening the foundation allows the entire system to become projective, preventive, and human—centered rather than disease-oriented," the ministry said.
Переведено сервисом «Яндекс Переводчик»
