Dear HIFA members,
The Lancet Global Health and Lancet Southeast Asia have published a series on primary health care in the region.
Executive Summary
'The South Asian region, home to more than one-fifth of the global population (1.74 billion), is at a crucial juncture in health system evolution, where it can leverage the new social and economic order to promote population health through primary health care services. The joint Series on Primary Health Care in South Asia evaluates the performance of PHC and its role in urban health, the integration of non-communicable disease services, and the contribution of community health workers in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. The Series also offers key recommendations for transforming PHC through priority actions such as policy contextualization, increased political commitment, multi-sectoral collaboration, meaningful public-private partnerships, and practice-oriented research.
'A strong and comprehensive PHC system is fundamental to achieving universal health coverage and enhancing the well-being of individuals. This collaborative effort not only informs future health reforms in South Asia but also provides valuable insights for other nations aiming to strengthen their PHC systems.'
Here are a few selected quotes from three of the papers:
'The quality of pre-service education remains low, with health curriculums not adapted to the evolving population health needs and input-based accreditation of teaching institutes, leading to suboptimal competencies of health staff'
DOI:https://doi.org/10.1016/S2214-109X(24)00119-0
'Training and educational requirements of CHWs vary across South Asia in content and length. All CHWs receive foundational training followed by refresher and specialized training (Table 2).12,6 Training is usually contextualized, participatory, and interactive, including real and simulated cases... CHWs need high-quality, contextualized, and individually-tailored pre-service and in-service training adapted based on their level of education and work experience.'
DOI:https://doi.org/10.1016/j.lansea.2024.100463
'All five countries [Bangladesh, India, Nepal, Pakistan, and Sri Lanka] have taken steps to increase the availability of trained health workers, but are yet to achieve the World Health Organisation's density threshold of 44.5 health workers for 10,000 people. The low quality of pre-service education remains an issue. Further, the maldistribution of health workers, lack of mentoring and professional support, workforce coordination issues, and the need for clear career progression pathways have been concerns across countries.' DOI:https://doi.org/10.1016/j.lansea.2024.100466
I was unable to find an overview of quality of care by different providers in different countries, nor about the contribution of access to relevant, reliable healthcare information and other determinants of quality.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
