Three Powers of Primary Health Care in Achieving Universal Health Coverage
By Lundi Anne Omam Ngo Bibaa, Assistant Executive Director of Reach Out Cameroon
Every country has been involved in providing some form of primary health care to their population. There are disparities among those who benefit and those who do not. The most vulnerable populations must often choose between access to quality health care or paying for medicines or food. This means that 100 million persons become poor every year just because they have to pay for care and millions die annually because they cannot access care (World Health Report 2010). Universal health coverage (UHC) is seen as the ‘magic pill’ needed to ensure the poor can equitably access health care without fear of becoming impoverished.
A lot of momentum has been built globally for countries to implement universal health coverage in a bid to achieve the sustainable development goals. It is well known that each country ought to implement a UHC scheme based on their needs, realities and what works for them (World Health Report, 2010). Despite the weakened state of most health systems, a revitalised primary health care system offers the best and most affordable pathway to bring health systems back on track and offer health for all. As governments meet in New York this for the first ever high-level meeting on UHC, they must take note of at least three powers primary health care has towards guaranteeing the achievement of UHC.
Three Powers of Primary Health Care in Achieving UHC:
1. Power to bring health closer the people: At a time when half of the world’s population still lacks access to basic health services, there is need to rethink how health systems are structured to enable everyone to access health care when ever needed. This brings to mind the community based polyclinic approached used in Cuba which ensures that the population has access to family doctors and nurses within a defined area. [1] Reach Out N.G.O’s uses a community-based model to prevent mother-to-child transmission of HIV in hard-to-reach, post-conflict communities in the Bakassi health district of Cameroon. In this model, Reach Out N.G.O established a network of health workers in every community of the Bakassi Health district, training them to provide home-based counselling and HIV testing, distribution of antiretroviral medication, and make referrals to pregnant women to the nearest health center. This availability of community-based HIV services, increased the number of pregnant women and male partners who were tested for HIV and increased the number of positive persons placed on treatment within the community.
2. Power to empower communities: Starting with the Alma-Ata declaration 1978, the concept of primary health care (PHC) stood for full community participation across all stages of planning, organisation, operation and control. A high-performing PHC system enables community members to hold policy makers and leaders accountable on the quality of services being delivered to them among other concerns and priorities. PHC should put communities as key actors within health systems, to decide what health care model works best for them and how resources can be used most equitably for the benefit of all. PHC ensures that communities have access to the information needed to make informed decisions about their health. For example, establishing community health committees can help involve individuals and families in the management of health activities within their communities. Some health management committees like those in Cameroon, oversee the functioning of health clinics in their communities.
3. Power to prevent and control epidemics: Every year, close to four million people die from ‘high-impact communicable diseases’. Improving primary health care systems would help prevent the occurrence of disease epidemics and control the spread. Miller et al (2018) highlighted the importance of community health workers in the ebola response in Guinea, Sierra Leone and Liberia. The successes learned from these three countries in controlling the spread of ebola demonstrates the power of strengthening the primary health care system to control epidemics. With the rise of epidemics in recent years, it is worthwhile building on the opportunities PHC offers to prevent and control disease outbreaks.
After the high-level meeting on UHC is over and the delegates, advocates and others return to their homes, we have an opportunity to turn rhetoric into reality. Let’s remember the power of primary health care to change people’s lives.
