First Contact: Primary Care is Essential to Universal Health Coverage
The first contact with health systems is critical for men, women and children with health needs. Primary health care is therefore an essential part of the work being done towards Universal Health Coverage (UHC); this is most evident in crisis situations. The Cox’s Bazar refugee camps in Bangladesh now host almost 1 million refugees in an area with already limited health service coverage. For these vulnerable populations, primary health care has successfully prevented large scale morbidity and mortality.
The International Organization for Migration (IOM), together with the Ministry of Health and Family Welfare, has been working towards upgrading primary health care centres in Cox’s Bazar to provide 24-hour services, particularly for pregnant women.
Mina*, is one of the many Rohingya refugees that have access to health care services at an IOM clinic in Cox’s Bazar. Her baby was delivered in an IOM clinic, which she chose specifically as the right place for this important occasion during a prior visit. “I know this centre provides all the health services I need in case of any problems. I was also sure, in case of an emergency, I would be transferred to another facility as the clinic has an ambulance,’’ Mina said.
IOM is one of the biggest medical providers in the Rohingya refugee camps; the Organization offers specialized services, including ultrasounds, which contribute to saving lives. In Cox Bazar, primary health care centres have been critical in the response to outbreaks of communicable disease, including diphtheria, measles and varicella. These inevitable outbreaks are managed by ensuring that refugees and host communities can access free, quality care when and where it is needed most.
World Health Day (7 April) is an occasion to remember that adequate health care is for all, including migrants. UHC aims to improve access to quality healthcare without leading patients into financial hardship. Strengthening primary health care — the first point of contact with health systems — is the most cost-effective way to achieve UHC for all.
Since January 2018, IOM has conducted over 938,406 patient consultations across the continuum of care, from primary health care to emergency referrals, antenatal care and delivery and mental health and psychosocial support consultations. Over 90 per cent of these consultations were for primary health care, delivered through 23 health facilities — a combination of IOM-run facilities and government run clinics supported by the Organization. Each week, an average of 62,000 patients seek care from these health centres.
IOM has been supporting the provision of primary health care for both refugees and host communities in Bangladesh for several years, including prior to the large-scale influx of refugees in 2017. Within the framework of UHC, the Organization’s approach to primary health care takes services for refugees as well as host communities into account. It is critical to support health systems approaches and all communities’ access to care, so that no one is left behind.
*Names have been changed.
