Primary healthcare is cornerstone of universal health coverage

Binagwaho, Agnès; Ghebreyesus, Tedros Adhanom

doi:10.1136/bmj.l2391

Cited by 69 publications

(50 citation statements)

References 2 publications

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“…Across the world, health systems are increasingly challenged by the complex needs of ageing populations, health workforce shortages and escalating costs [ 1 , 2 ]. Amidst these challenges, there is a pressing need to develop effective and efficient primary health services to contribute to the global goal of universal health coverage [ 3 ]. In many countries, including the UK, current debates focus on achieving the optimum skill mix within primary care and the optimum models of service provision [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation

Evans

Pearce

Greaves

et al. 2020

IJERPH

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Escalating costs and changing population demographics are putting pressure on primary care systems to meet ever more complex healthcare needs. Non-medical ‘advanced clinical practitioner’ (ACP) roles are increasingly being introduced to support service transformation. This paper reports the findings of a qualitative evaluation of nursing ACP roles across General Practices in one region of the UK. Data collection involved telephone interviews with 26 participants from 3 different stakeholder groups based in 9 practice sites: ACPs (n = 9), general practitioners (n = 8) and practice managers (n = 9). The data was analysed thematically. The study found a high degree of acceptance of the ACP role and affirmation of the important contribution of ACPs to patient care. However, significant variations in ACP education, skills and experience led to a bespoke approach to their deployment, impeding system-wide innovation and creating challenges for recruitment and ongoing professional development. In addition, a context of high workforce pressures and high service demand were causing stress and there was a need for greater mentorship and workplace support. System wide changes to ACP education and support are required to enable ACPs to realise their full potential in primary care in the UK.

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Section: Introductionmentioning

confidence: 99%

Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation

Evans

Pearce

Greaves

et al. 2020

IJERPH

View full text Add to dashboard Cite

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“…2 It has been acknowledged that achieving the health-related sustainable development goals, including universal health coverage (UHC), will not be possible without stronger PHC. 2 3 …”

Section: Introductionmentioning

confidence: 99%

Assessment of resources for primary health care: Implications for the revitalization of primary health care in Akwa Ibom, Nigeria

2020

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Context: Primary health care (PHC) is the cornerstone of the Nigerian National Health Policy. The national policy on PHC under one roof is undergoing implementation nationwide as a means of strengthening the PHC system. Akwa Ibom State (AKS) is set to commence full implementation of the policy. Aims: The aim of the study was to assess the existing human resource and infrastructure in PHC facilities in AKS. Settings and Design: A descriptive cross-sectional study was carried out in 18 facilities selected from the three senatorial zones of AKS, Nigeria. Subjects and Methods: A rapid assessment of selected PHC facilities based on a checklist adapted from the minimum standards for PHC as provided by the National PHC Development Agency. The results were analyzed using Excel and presented in tables. Results: A total of 18 health facilities were included in the study. Human resources available were 276 full time core health workers, of which 48 (17.4%) were volunteer workers. There was inequitable distribution in district and facility type as 122(44.2%) work in Ikot Ekpene Senatorial district and 242 (87.7%) of them work in the Operational Base. Basic lifesaving equipment such as resuscitation sets was unavailable in more than 50% of the health facilities. Conclusions: There are absolute deficit and inequitable distribution of available human resources in AKS PHCs. Basic-lifesaving equipment is grossly inadequate. There is an urgent need for more health workers to be employed and provision of basic equipment for the PHCs.

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“…The global community has prioritised achieving UHC by 2030, of which PHC must be a foundational cornerstone. 49 We describe Costa Rica’s road map for PHC improvement from initial exploration through preparation, implementation and sustainment. We show that in addition to many facilitating contextual factors, Costa Rica health leaders were intentional in their planning and implementation of the PHC model, which was comprehensive by design, prioritising both individual and population care and prevention within their PHC model.…”

Section: Discussionmentioning

confidence: 99%

Implementing sustainable primary healthcare reforms: strategies from Costa Rica

et al. 2020

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As the world strives to achieve universal health coverage by 2030, countries must build robust healthcare systems founded on strong primary healthcare (PHC). In order to strengthen PHC, country governments need actionable guidance about how to implement health reform. Costa Rica is an example of a country that has taken concrete steps towards successfully improving PHC over the last two decades. In the 1990s, Costa Rica implemented three key reforms: governance restructuring, geographic empanelment, and multidisciplinary teams. To understand how Costa Rica implemented these reforms, we conducted a process evaluation based on a validated implementation science framework. We interviewed 39 key informants from across Costa Rica’s healthcare system in order to understand how these reforms were implemented. Using the Exploration Preparation Implementation Sustainment (EPIS) framework, we coded the results to identify Costa Rica’s key implementation strategies and explore underlying reasons for Costa Rica’s success as well as ongoing challenges. We found that Costa Rica implemented PHC reforms through strong leadership, a compelling vision and deliberate implementation strategies such as building on existing knowledge, resources and infrastructure; bringing together key stakeholders and engaging deeply with communities. These reforms have led to dramatic improvements in health outcomes in the past 25 years. Our in-depth analysis of Costa Rica’s specific implementation strategies offers tangible lessons and examples for other countries as they navigate the important but difficult work of strengthening PHC.

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Primary healthcare is cornerstone of universal health coverage

Abstract: Now we must reinvent primary care to make it happen

Cited by 69 publications

References 2 publications

Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation

Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation

Assessment of resources for primary health care: Implications for the revitalization of primary health care in Akwa Ibom, Nigeria

Implementing sustainable primary healthcare reforms: strategies from Costa Rica

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