Dana Hovig, Tim Evans and Edward Kelley emphasise why strong primary health care systems matter, and introduce a new partnership – the Primary Health Care Performance Initiative – to catalyse improvements in primary health care in low- and middle-income countries.
An elderly woman visits her local clinic with a lingering cough. Her primary care provider asks questions and examines her, and finding nothing serious and noting no concerns for epidemic illness, she correctly diagnoses a viral illness and recommends rest and fluids. She notes that she should feel better in a week or two, but if she doesn’t, or if she gets sicker, she should return. Because she has cared for this woman for years, she asks her how her blood pressure treatment is going, and if she would be interested in discussing her smoking. She also reviews her records and makes sure she has had all recommended vaccines.
This story offers a picture of what primary health care can and should be: the front line of health care, providing a spectrum of health services – both public and private – and placing people, rather than diseases, at the centre of care. When a primary health care system works well, it can meet the vast majority of people’s health needs, and engage the whole community in improving health outcomes. But when the system fails to work – as we saw during the Ebola crisis – the consequences can be devastating.
It is true that the last five decades have seen great improvements in the health of populations worldwide, and the importance of primary health care has long been recognised as fundamental to achieving health and development goals. Formal calls for improving primary health care began in 1978, when the Declaration of Alma- Ata expressed the need for urgent national and international action. In the nearly 40 years since, a number of other declarations and initiatives on primary health care have followed suit, from the Bamako Initiative in 1987 to the Abuja Call on HIV, TB and Malaria in 2006…
*Statistics within article correct at original publication date of CHOGM 2015 Report.
Dana Hovig, Tim Evans and Edward Kelley
Primary Health Care Performance Initiative