Building and Sustaining a Robust Primary Health Care System: Lessons from Country Experiences
Keywords:
Primary health care, general practice, universal health coverage, family medicine, family health team, gatekeeper, community participation, intersectoral coordination
Abstract
Primary health care has been long acknowledged as the fundamental pillar of any health system, and a key instrument for achieving efficient, equitable, and universal health care. While accepting the significance of primary health care to be sacrosanct,
little recognition is often accorded to the systemic prerequisites of a strong primary health care system, even as efforts to expand and/or strengthen primary care continue fervently. An attempt has been made in this paper to identify such prerequisites through a review of notable country examples and their present and past experiences. These pertain not just to
the health sector but also straddle multiple important social, economic, and political dimensions.
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2. Bhaduri SD. Japan: Health Care System Overview and SWOT Analysis. The Indian Practitioner. 2021;74(1):29-32.
3. Ikegami N. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- andFeb 25;5(5):291-3.
4. Keck CW, Reed GA. The curious case of Cuba. Am J Public Health. 2012 Aug;102(8):e13-22.
5. Garcia GD. El servicio médico rural en Cuba: ante-cedentes y desarrollo histórico, Cuadernos de la Historia de la Salud
Pública #72. Havana, Cuba: Ministry of Public Health; 2018.
6. Cooper RS, Kennelly JF, Orduñez-Garcia P. Health in Cuba. Int J Epidemiol. 2006 Aug;35(4):817-24.
7. Gómez Dantés O. The Dark Side of Cuba’s Health System: Free Speech, Rights of Patients and Labor Rights of Physicians. Health Syst Reform. 2018;4(3):175-182.
8. Thaiprayoon S, Wibulpolprasert S. Political and policy lessons from Thailand’s UHC experience. ORF Issue Brief. 174; 2002.
9. Tangcharoensathien V, Patcharanarumol W, Ir P, Aljunid SM, Mukti AG, Akkhavong K, Banzon E, Huong DB,
Thabrany H, Mills A. Health-financing reforms in southeast Asia: challenges in achieving universal coverage. Lancet.
2011 Mar 5;377(9768):863-73.
10. Nitayarumphong S. Evolution of primary health care in Thailand: what policies worked? Health Policy and Planning.
1990 Sep;5(3):246–254.
11. Tangcharoensathien V, Limwattananon S, Suphanchaimat R, Patcharanarumol W, Sawaengdee K, Putthasri W. Health
workforce contributions to health system development: a platform for universal health coverage. Bulletin of the World
Health Organization. 2013;91(11):874–880.
12. Bloom G. Universal Health Coverage and Primary Healthcare: Lessons From Japan Comment on “Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries”. Int J Health Policy Manag. 2017 Apr 1;6(4):229-231.
13. World Health Organization. Successful Health System Reforms: The Case of Turkey. WHO Regional Office for Europe. 2012 May.
14. Atun R, Aydın S, Chakraborty S, Sümer S, Aran M, Gürol I, Nazlıoğlu S, Ozgülcü S, Aydoğan U, Ayar B, Dilmen U,
Akdağ R. Universal health coverage in Turkey: enhancement of equity. Lancet. 2013 Jul 6;382(9886):65-99.
15. Sumer S. Case study for People Centered Health Care in Turkey Final Report. World Bank. 2015.
16. PHCPI [Internet]. Turkey: Greater availability of primary care services results in high patient and physician satisfaction.
[Cited 2021 April 25].Available at: https://improvingphc. org/promising-practices/turkey.
17. Hone T, Gurol-Urganci I, Millett C, Başara B, Akdağ R, Atun R. Effect of primary health care reforms in Turkey on health
service utilization and user satisfaction. Health Policy Plan. 2017 Feb;32(1):57-67.
18. Massuda A, Hone T, Leles FAG, de Castro MC, Atun R. The Brazilian health system at crossroads: progress, crisis and resilience. BMJ Glob Health. 2018 Jul 3;3(4):e000829.
19. Wadge H, Bhatti Y, Carter A, Harris M, Parston G, Darzi A. Brazil’s Family Health Strategy: Using Community Health Workers to Provide Primary Care. The Commonwealth Fund. 2016. Available from: https://www.commonwealthfund. org/publications/case-study/2016/dec/brazils- family-health-strategy-using-community-healthcare- workers#:~:text=Brazil%2C%20the%20world’s%20 fifth%2Dlargest,nurses%20or%20physicians%2C%20 and%20collect
20. Macinko J, Guanais FC, de Fátima M, de Souza M. Evaluation of the impact of the Family Health Program on infant mortality
in Brazil, 1990-2002. J Epidemiol Community Health. 2006 Jan;60(1):13-9.
21. Rocha R, Soares RR. Evaluating the impact of communitybased health interventions: evidence from Brazil’s Family Health Program. Health Econ. 2010 Sep;19 Suppl:126-58.
22. Liseckiene I, Boerma WG, Milasauskiene Z, Valius L, Miseviciene I, Groenewegen PP. Primary care in a post-communist
country 10 years later Comparison of service profiles of Lithuanian primary care physicians in 1994 and GPs in 2004.
23. Atun RA, Menabde N, Saluvere K, Jesse M, Habicht J. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation). Health Policy. 2006 Nov;79(1):79-91.
24. Gadallah MA, Allam MF, Ahmed AM, El-Shabrawy EM. Are patients and healthcare providers satisfied with health sector reform implemented in family health centres? Qual Saf Health Care. 2010 Dec;19(6):e4.
25. Jaturapatporn D, Dellow A. Does Family Medicine training in Thailand affect patient satisfaction with primary care doctors?
BMC Fam Pract. 2007 Mar 29;8:14.
26. Light DW. Universal health care: lessons from the British experience. Am J Public Health. 2003 Jan;93(1):25-30.
27. Bodenheimer TS, Grumbach K. Understanding health policy: a clinical approach. 5th ed. McGraw-Hill; 2008.
28. Stevens RA. The Americanization of family medicine: contradictions, challenges, and change, 1969-2000. Fam Med.
2001 Apr;33(4):232-43.
29. Banerjee A. Family medicine in India: Losing the way in spite of the map. Medical Journal of Dr. DY Patil University.
2016;9:1-3. Middle-Income Countries. Int J Health Policy Manag. 2016
Published
2022-01-31
How to Cite
Dr. Soham D. Bhaduri. (2022). Building and Sustaining a Robust Primary Health Care System: Lessons from Country Experiences. The Indian Practitioner, 75(1), 21-29. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1298
Section
Special Article
