Committing to Primary Health Care to achieve health for all

This important meeting coincides with the 40th anniversary of the original Primary Health Care Declaration made in Alma-Ata, Kazakhstan in 1978. The Declaration expresses the need for urgent action by all governments, all health and development workers, and the world community to protect and promote health for all.

Primary health care isn’t just about frontline health services. It’s about ensuring a country’s health system is strong enough to cater for the needs of its population throughout their lives. It’s about ensuring that affordable services are easily accessible, providing quality care and that staff are well-trained. It’s also about empowering communities to understand their right to health and equipping civil society to hold governments to account for their commitments.

Despite progress and improvements in health indicators over the last 40 years, half of the world’s population lacks access to essential health services and 100 million people are driven into poverty paying for health each year.

Options is committed to working with its partners to achieve universal health coverage in some of the world’s poorest and most fragile contexts.

Jo Elms, Managing Director at Options, says; “Strengthening health systems is vital for reaching the SDG3 target of Universal Health Coverage and offers all of us working in this area tremendous opportunities to further advance global health outcomes by 2030.”

Over the last 20 years, our work in Nepal has focused on enabling women to access the healthcare they need by overcoming financial, geographic and social barriers. By working alongside the government, we’ve established a trusted relationship to support the strengthening of its health system and delivery of its health strategy. One such example is the health financing scheme we designed in 1997, that provided transport subsidies for pregnant women to access care. Today it’s an inherent part of government provision.

In Kenya, we’ve supported one of the country’s poorest counties, Bungoma, to deliver better access to high quality health services in the context of devolution. Bungoma county government now has the capacity to ensure health services are planned and budgeted for, so that facilities have the equipment, drugs and staff they need to deliver quality services. We have trained community health volunteers to support women throughout their pregnancy, and educated mothers in pre- and post-natal care. Through our voucher programme, over 40,000 women from poor communities can now access safe delivery services that they previously could not afford due to the cost of transportation.

This year, we’ve been supporting the work of the Global Financing Facility (GFF). Our E4A-MamaYe programme is working across Africa to strengthen civil society engagement with the GFF to ensure money raised by, given, and lent to governments is spent where it is needed most to improve reproduction, maternal, newborn, children and adolescent health and nutrition (RMNCAH-N). In October, we brought together CSOs from 10 Francophone countries to strengthen their understanding of the GFF and learn from each other’s experiences in engagement with the GFF. In Kenya, a coalition of civil society, supported by E4A, has successfully developed a scorecard to monitor Government commitments to establishing a functional GFF country level mechanism, and improving RMNCAH-N outcomes as a result.

Building on this work, we call for countries to recognise the high economic value of successful investment in health relevant to cost and for global health leaders to recognise the following key steps in achieving better health for all:

• Develop structures and processes that support equity to address disparities in health outcomes and access to care between the country’s ethnic/caste groups, income groups and between people living in different regions.
• Quality of care is essential for building health systems that improve health care for all and that optimise health care in each given context. Quality should not be the purview of the elite or an aspiration for some distant future; it should be the DNA of all health systems.
• Increased spending and more effective financing models through national systems to finance specific interventions that provide good value for money and improve health equity is key to achieving UHC.

Marking this important anniversary, we reconfirm our commitment to strengthening primary health care in the countries we work in, and to taking forward the principles enshrined in the new Astana Declaration.