Primary healthcare policy implementation in South Asia

Abstract

Primary healthcare is considered an essential feature of health systems to secure population health and contain costs of healthcare while universal health coverage forms a key to secure access to care. This paper is based on a workshop at the 2016 World Organization of Family Doctors (WONCA) South Asia regional conference, where the health systems of Bangladesh, India, Nepal, Pakistan and Sri Lanka were presented in relation to their provision of primary healthcare. The five countries have in recent years improved the health of their populations, but currently face the challenges of non-communicable diseases and ageing populations. Primary healthcare should be a core component in restructuring health systems. However, there is a lack of understanding among policymakers of the unique contribution of primary healthcare to the health of populations. This results in insufficient investment in facilities and low priority of specialty training in the community setting. Regional collaboration could strengthen the advocacy for primary healthcare to policymakers and other stakeholders. Priorities were investment in community-based health facilities, and access to healthcare through professionals specialty-trained in the primary healthcare setting. This development fits the strategy of the WHO South East Asian Region to use community-based healthcare in achieving universal health coverage for the Asian populations.

Unfulfilled potential of primary care in Europe

“…Primary care can manage 90% of all health system interactions, making it central to the realisation of universal health coverage 56. Over recent decades, improvements in the quality and coverage of primary care have delivered important population health gains around the world 3789101112…”

“…Experience from other continents shows that state regulators often restrict the practice of primary care professionals to individual level functions and disproportionately direct regulatory measures to public sector practices (which may be more likely to consider public health than their private counterparts) 836…”

Advancing universal health coverage in South Asian cities: a framework

“…In most South Asian cities, public sector service delivery is strong at the tertiary level but overcrowded as government hospitals serve city residents as well as patients from around the country 23. Research suggests that the public system has been unable to provide universal access to the required range of primary health services additional to maternal and child healthcare 524.…”

Commentary: Primary Health Care Delivery Services in the World

“…In the Asian continent, the PHCs are faced with a lot of challenges which may include low financial input, poor or inadequate infrastructural facilities as well as widened socio-economical gap in the continent's health centres [26,27].…”