van Weel Chris, Kassai Ryuki, Qidwai Waris, Kumar Raman, Bala Kanu, Prasad Gupta Pramendra, Haniffa Ruvaiz, Rajapaksa Hewageegana Neelamani, Ranasinghe Thusara, Kidd Michael, Howe Amanda
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Division of Health Services Research and Policy, Research School of Population Health, Australian National University, Acton, Australian Capital Territory, Australia.
BMJ Glob Health. 2016 Sep 6;1(2):e000057. doi: 10.1136/bmjgh-2016-000057. eCollection 2016.
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.
初级卫生保健被视为卫生系统的一项基本特征,以保障民众健康并控制医疗保健成本,而全民健康覆盖则是确保获得医疗服务的关键。本文基于2016年世界家庭医生组织(WONCA)南亚区域会议的一个研讨会,会上介绍了孟加拉国、印度、尼泊尔、巴基斯坦和斯里兰卡的卫生系统及其提供初级卫生保健的情况。这五个国家近年来改善了民众健康状况,但目前面临非传染性疾病和人口老龄化的挑战。初级卫生保健应成为卫生系统重组的核心组成部分。然而,政策制定者对初级卫生保健对民众健康的独特贡献缺乏认识。这导致对设施的投资不足,以及社区环境中专科培训的优先级较低。区域合作可以加强对政策制定者和其他利益相关者的初级卫生保健宣传。优先事项包括对社区卫生设施的投资,以及通过在初级卫生保健环境中接受专科培训的专业人员获得医疗服务。这一发展符合世界卫生组织东南亚区域利用社区卫生保健实现亚洲民众全民健康覆盖的战略。