The role of Primary Health Care, primary care and hospitals in advancing Universal Health Coverage

Allen, Luke N; Pettigrew, Luisa M; Exley, Josephine; Nugent, Rachel; Balabanova, Dina; Villar-Uribe, Manuela; Baatiema, Leonard; Shubber, Zara; Mugambi, Joy; Kidd, Michael; Zewdie, Anteneh; Padula, Inez; Abimbola, Seye

doi:10.1136/bmjgh-2023-014442

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Finally, the data is confined to one country, South Korea. Primary healthcare is highly valued worldwide 56 . However, contrary to this, according to statistics from the World Health Organization, many countries suffer from poor access to primary healthcare 57 , 58 .…”

Section: Discussionmentioning

confidence: 99%

National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022

Kattih,

Lee,

et al. 2024

Sci Rep

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Previous studies have examined the prevalence of allergic diseases in adolescents 1–2 years after the emergence of the COVID-19 pandemic. However, more data is needed to understand the long-term impact of COVID-19 on allergic diseases. Thus, we aimed to examine the trend of the atopic dermatitis prevalence in Korean adolescents before and during the COVID-19 pandemic across 14 years. Additionally, we analyze the risk factors of atopic dermatitis (AD) based on the results. The Korean Disease Control and Prevention Agency conducted the Korea Youth Risk Behavior Web-based Survey from 2009 to 2022, from which the data for this study were obtained. Prevalence trends were compared across subgroups, and the β difference (βdiff) was calculated. We computed odds ratios to examine changes in the disease prevalence before and during the pandemic. This study included a total of 917,461 participants from 2009 to 2022. The prevalence of atopic dermatitis increased from 6.79% (95% CI 6.66–6.91) in 2009–2011 to 6.89% (95% CI 6.72–7.05) in 2018–2019, then decreased slightly to 5.82% (95% CI 5.60–6.04) in 2022. Across the 14 years, middle school student status, low parent’s highest education level, low household income, non-alcohol consumption, non-smoker smoking status, no suicidal thoughts, and no suicide attempts were associated with increased risk of atopic dermatitis, while female sex, rural residence, high BMI, low school performance, low household income, and no feelings of sadness and despair was associated with a small increase. This study examined the prevalence of atopic dermatitis across an 18-year, and found that the prevalence increased in the pre-pandemic then decreased during the start of the pandemic and remained constant throughout the pandemic. This trend could be explained mainly by the large scale social and political changes that occurred during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022

Kattih,

Lee,

et al. 2024

Sci Rep

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“…The concept of primary healthcare (PHC) was thus born, with the aim of improving community participation in managing their own health [2]. Since then, the concept has had mixed fortunes, with results that have sometimes been severely criticised [3], ranging from differing understandings among experts to incomplete implementation influenced by other agendas driven by some international institutions [4]. But on balance, investment in strong primary care has been widely described as one of the most cost-effective and equitable ways [5] of moving towards universal health coverage [3,6].…”

Section: Introductionmentioning

confidence: 99%

“…Since then, the concept has had mixed fortunes, with results that have sometimes been severely criticised [3], ranging from differing understandings among experts to incomplete implementation influenced by other agendas driven by some international institutions [4]. But on balance, investment in strong primary care has been widely described as one of the most cost-effective and equitable ways [5] of moving towards universal health coverage [3,6]. Several countries, including Burkina Faso, then adopted and began implementing PHC and tried to operationalise it through several initiatives.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Communities’ Satisfaction of Receiving Curative Care Administered by Community Health Workers in the Health Districts of Boussé and Boussouma in Burkina Faso, 2024

Ouedraogo,

Sawadogo,

Kabore

et al. 2024

Preprint

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Background: Since 2010, Burkina Faso has developed and initiated community-based management of childhood illnesses. Following the increased presence of community health workers and the adoption of free community health care, this study aims to assess community satisfaction with curative care administered by community health workers. Methodology: It was a descriptive and analytical cross-sectional study. Data were collected in the health districts of Boussé and Boussouma from 20 February to 30 March 2023 for quantitative data and from 12 to 30 January 2024 for qualitative data using a questionnaire (household survey) and an interview grid (focus groups). Analyses were conducted using SPSS IBM 25 and Nvivo 14. Results: Households benefit from oral curative care when using CHWs, but are not satisfied with the temporal accessibility of these community health workers. Temporal accessibility and awareness during care have a significant influence on household satisfaction. Conclusion: Curative care by community health workers is effective, but its use could be improved by addressing the unavailability of community health workers, inputs and better communication during care.

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“…PHC’s far-reaching promises of universal health coverage (UHC) [4, 29, 35] and equity [4, 29, 36] strengthen the appeal of uniform concepts silencing the critical debate and eventual emerging controversies pertaining to strategies, actors and future directions [12, 20, 32, 37–38]. Crucially, governance largely remains a black box, hiding the systematic analysis of transformative capacities and making PHC workforce governance poorly prepared for the implementation challenges embedded in politics, policy, and the powers of stakeholders within health systems.…”

Section: Introductionmentioning

confidence: 99%

Tackling the primary healthcare workforce crisis: time to talk about health systems and governance. A comparative assessment of the European region

Kuhlmann,

Falkenbach,

Brinzac

et al. 2024

Preprint

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BackgroundPrimary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to identify transformative capacities in health system contexts.MethodsA qualitative comparative methodology was employed, and a rapid assessment of the primary healthcare workforce was conducted across nine countries: Denmark, Germany, Kazakhstan, Netherlands, Portugal, Romania, Serbia, Switzerland, and the United Kingdom/ England.ResultsOur findings reveal both convergence and pronounced diversity across the healthcare systems, with none fully aligning with the ideal attributes of primary healthcare suggested by WHO. However, across all categories, Denmark, the Netherlands, and to a lesser extent Kazakhstan, depict closer alignment to this model than the other countries. Workforce composition and skill-mix vary strongly, while disparities persist in education and data availability, particularly within Social Health Insurance systems. Policy responses and interventions span governance, organisational, and professional realms, although with weaknesses in the implementation of policies and a systematic lack of data and evaluation. The WHO primary healthcare model only marginally informs policy decisions, with the exception being in Kazakhstan.ConclusionWe conclude that aligning primary healthcare and workforce considerations within the broader health system context may help move the debate forward and build governance capacities to improve resilience in both areas.

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The role of Primary Health Care, primary care and hospitals in advancing Universal Health Coverage

Cited by 4 publications

References 7 publications

National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022

National prevalence of atopic dermatitis in Korean adolescents from 2009 to 2022

Factors Associated with Communities’ Satisfaction of Receiving Curative Care Administered by Community Health Workers in the Health Districts of Boussé and Boussouma in Burkina Faso, 2024

Tackling the primary healthcare workforce crisis: time to talk about health systems and governance. A comparative assessment of the European region

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