Hi,
I think the discussion around the word "essential" in health services is a really important and interesting one. I would like to put forward the argument that "essential" should refer to the set of effective services of lowest complexity and lowest cost that should be provided to everyone who needs them in all settings in the world. This is how it was used in a recent consensus around Essential Emergency and Critical Care that a global group published in September (declaration: I was one of the authors) https://gh.bmj.com/content/6/9/e006585
In my opinion, it is important to keep the content of "essential" packages simple and low-cost. Such care is likely to be cost-effective and is, by definition, the most feasible to introduce. Care that is simple and low-cost risks being under-prioritised or neglected if more high-tech or glamorous care are included in essential packages.
Settings with the resources to provide more than the essential care should do so - the argument is not to provide the essential care and then stop. Essential care should always be available and provided, and other care added as resources allow.
Yours
Tim
HIFA profile: Tim Baker is a Physician and Researcher in Anaesthesia and Intensive Care. He is a member of faculty at Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and has appointments at Ifakara Health Institute in Dar es Salaam and Karolinska Institutet and Karolinska University Hospital in Stockholm, Sweden. Tim’s interest is in global emergency and critical care, focusing on evaluating and improving health services and health systems for the provision of good quality care to critically ill patients in low-resource settings. tim.baker AT ki.se
