South Asian countries face many common health challenges due to non-communicable diseases, ageing populations, rapid urbanization, socio-economic inequalities, low public spending on health, etc. Reorienting health systems towards primary health care can be a cost-effective strategy to address these challenges in South Asia and other low- and middle-income countries.
a New Series Publication year The Lancet Global Health and of The Lancet Regional Health Southeast Asia Lessons learned from implementing primary health care programs in five countries: Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Global Launch Event Organizer Lancet A session exploring learnings from the series will be held on October 1, 2024 at 9:00 AM EDT.
The series, edited by Krishna D. Rao, PhD (M.S. ’04), Associate Professor of Global Health, provides recommendations for improving primary health care in South Asia. Key themes in the series include the growing burden of non-communicable diseases that disproportionately affect marginalized populations, growing urban populations leading to socio-economic inequalities and health disparities, and the critical role of community health workers in improving population health and the importance of investing in them.
Noncommunicable diseases: This area is Noncommunicable diseasesThe region has a high prevalence of non-communicable diseases, including heart disease, diabetes, cancer, and chronic respiratory diseases, as well as high rates of modifiable risk factors, such as smoking, alcohol consumption, unhealthy diet, and physical inactivity. Although there is a political commitment to address NCDs throughout the region, there are challenges to doing so, including a lack of human resources and essential medicines, and inadequate funding. The authors emphasize integrating NCDs into the primary care system by implementing early detection of NCDs at the primary care level, funding an uninterrupted supply of essential NCD medicines and technologies that can be provided in primary care facilities, and improving health workers’ NCD care capacity.
City Health: South Asia Rapid urbanizationCities in the region face the challenge of providing quality health care and healthy living and working environments for all their residents. Cities in the region face significant health inequities. Addressing these challenges through primary health care requires a multi-sectoral response, including effective resource pooling by urban local governments for housing and sanitation, and increased public funding for health. “Policies need to ensure quality services and financial protection through the expansion of public sector services and strategic engagement with private service providers, especially those serving low-income urban populations,” says Rao, lead author of the urban health paper. Lancet series.
Community Health Workers: Community health workers The backbone of primary health care service deliveryCurrent and future health challenges in South Asia require further adaptation of community health worker (CHW) programs. However, in many South Asian countries, CHWs are not formally recognized within the health system and are not appropriately treated or paid as professional health workers. Strengthening CHW programs in South Asia requires sufficient, dedicated, and consistent public funding; supported career paths that promote professional development; clarification of roles and responsibilities; and better integration into the health workforce.
The series concludes with nine action items for policy and decision makers to implement. Realigning health systems to primary health care:
- Contextualizing policies on primary health care.
- Expanding innovation.
- Allocate appropriate financial resources.
- Strengthen the governance function of the Ministry of Health.
- Establishing meaningful public-private partnerships.
- Use of digital health tools.
- Reorganization of service delivery.
- Implementing an effective change management process
- Encourage practice-oriented research.
Finally, increasing research, policy and practice networks on primary health care in South Asia can generate evidence, strengthen advocacy and provide a space for peer learning.
