Primary health care (PHC) is a pivotal foundation for equitable progress toward universal health coverage. Comprehensive, quality-assured PHC can potentially address 80-90% of lifetime population health needs. Experiences from the COVID-19 pandemic have underlined the importance of strong, universal PHC systems that equitably and efficiently protect communities from public health emergencies.
Recently, the Lancet Global Health Commission on Financing PHC proposed a re-thinking on how countries can prioritize PHC by “investing more and investing better.” For example, governments typically focus on providing outpatient services from PHC budget, while medicines and diagnostics are mostly paid out-of-pocket. In other instances, the political priority is often to finance hospitalization benefits over PHC. There is a need to change such approaches which contribute to increasing inequitable health outcomes and financial risks for poorer and vulnerable sections.
The goal of this Research Topic is to contribute to the understanding of how low- and middle-income countries (LMICs) can progress toward developing universal PHC systems that are appropriately organized and adequately funded, to cater to population health needs while offering complete financial risk protection. It is recognized that health systems across LMICs are in varying stages on this path, and governments face a difficult challenge in mobilizing domestic resources following the pandemic-related economic contraction and its impact on GDP and fiscal space. However, the need to invest in universal PHC systems has never been greater, as noted in World Bank’s Sixth Annual Health Financing Forum.
This Research Topic aims to portray success stories/ best practices from LMICs that have progressed along this path, as well as situational analyses and evidence-based blueprints for progress from others who face unique challenges. For the purpose of this collection, the operational definition of PHC has been borrowed from Lancet Commission, as a "service delivery level or platform, together with the human and other resources needed for it to function effectively." The editors of this collection encourage authors to think about this platform as the first point of contact with the health system – typically, the primary health center, affiliated sub-health centers/ health posts, and linked outreach programs. While some PHC services are delivered at secondary and tertiary care hospitals, the idea is to limit the boundaries of this platform outside of hospital-based care provision.
Considering these points, this collection welcomes submissions of Original Research, Systematic Reviews, and Perspectives. The use of clear conceptual frameworks and evidence to design, analyze, and propose context-specific solutions is encouraged. Authors are welcome to consider, but not be limited by, the following themes:
1. Examining organizational and financial aspects of national/ sub-national PHC systems or using examples of a specific PHC component, like reproductive, maternal, newborn, and child health (RMNCH) programs to bring out:
• Unique strengths in equitable population and service coverage, and financial risk protection;
• Best practices, replicable in comparable settings;
• Shortcomings, and blueprint for context-appropriate reforms.
2. Examining challenges with regards to:
• Revenue generation (e.g., specific taxes, insurance contributions, development assistance for health);
• Pooling prepaid revenues through various sources (health insurance funds, national health ministries, local govt) to allow for redistribution to individuals with the greatest health needs;
• Purchasing PHC services/ allocation of pooled funds to providers.
3. Evaluating and drawing lessons from past efforts (programs and policies) to reform PHC.
The Topic Editors Ayan Jha and Eduardo González-Pier are employed by Palladium, a private, global impact firm based in Washington, DC. All other Topic Editors declare no competing interests with regard to the Research Topic subject.
Primary health care (PHC) is a pivotal foundation for equitable progress toward universal health coverage. Comprehensive, quality-assured PHC can potentially address 80-90% of lifetime population health needs. Experiences from the COVID-19 pandemic have underlined the importance of strong, universal PHC systems that equitably and efficiently protect communities from public health emergencies.
Recently, the Lancet Global Health Commission on Financing PHC proposed a re-thinking on how countries can prioritize PHC by “investing more and investing better.” For example, governments typically focus on providing outpatient services from PHC budget, while medicines and diagnostics are mostly paid out-of-pocket. In other instances, the political priority is often to finance hospitalization benefits over PHC. There is a need to change such approaches which contribute to increasing inequitable health outcomes and financial risks for poorer and vulnerable sections.
The goal of this Research Topic is to contribute to the understanding of how low- and middle-income countries (LMICs) can progress toward developing universal PHC systems that are appropriately organized and adequately funded, to cater to population health needs while offering complete financial risk protection. It is recognized that health systems across LMICs are in varying stages on this path, and governments face a difficult challenge in mobilizing domestic resources following the pandemic-related economic contraction and its impact on GDP and fiscal space. However, the need to invest in universal PHC systems has never been greater, as noted in World Bank’s Sixth Annual Health Financing Forum.
This Research Topic aims to portray success stories/ best practices from LMICs that have progressed along this path, as well as situational analyses and evidence-based blueprints for progress from others who face unique challenges. For the purpose of this collection, the operational definition of PHC has been borrowed from Lancet Commission, as a "service delivery level or platform, together with the human and other resources needed for it to function effectively." The editors of this collection encourage authors to think about this platform as the first point of contact with the health system – typically, the primary health center, affiliated sub-health centers/ health posts, and linked outreach programs. While some PHC services are delivered at secondary and tertiary care hospitals, the idea is to limit the boundaries of this platform outside of hospital-based care provision.
Considering these points, this collection welcomes submissions of Original Research, Systematic Reviews, and Perspectives. The use of clear conceptual frameworks and evidence to design, analyze, and propose context-specific solutions is encouraged. Authors are welcome to consider, but not be limited by, the following themes:
1. Examining organizational and financial aspects of national/ sub-national PHC systems or using examples of a specific PHC component, like reproductive, maternal, newborn, and child health (RMNCH) programs to bring out:
• Unique strengths in equitable population and service coverage, and financial risk protection;
• Best practices, replicable in comparable settings;
• Shortcomings, and blueprint for context-appropriate reforms.
2. Examining challenges with regards to:
• Revenue generation (e.g., specific taxes, insurance contributions, development assistance for health);
• Pooling prepaid revenues through various sources (health insurance funds, national health ministries, local govt) to allow for redistribution to individuals with the greatest health needs;
• Purchasing PHC services/ allocation of pooled funds to providers.
3. Evaluating and drawing lessons from past efforts (programs and policies) to reform PHC.
The Topic Editors Ayan Jha and Eduardo González-Pier are employed by Palladium, a private, global impact firm based in Washington, DC. All other Topic Editors declare no competing interests with regard to the Research Topic subject.
