Primary Health Care 2.0

India’s G20 presidency: An agenda for Primary Health Care

It has been one of the priority areas for G20 deliberations since 2017 when the German presidency organised the first meeting of health ministers of G20 countries.
The G20 now has a financial stream for health finance and a Sherpa stream for health system development.
The importance of the subject is reflected in an annual G20 meeting of health ministers and a joint health and finance task force.
Health systems strengthening has engaged the global community in thinking through the content and directions.
A PHC-with-UHC approach entails strengthening primary-level care through whole-of-society and whole-of-government approaches and extending the “PHC principles” to secondary and tertiary care services.

Universal Health Coverage (UHC)
- By universalizing health insurance coverage, the concept of UHC was born in the 2000s to prevent catastrophic medical expenditures due to secondary and tertiary-level hospital services.
UHC is a strategy to ensure healthcare for all
- Since 2010, the UHC has been the major global approach for strengthening health systems.
- It was also adopted in 2015 as the strategy for SDG-3 to ensure healthcare for all ages.
Limited impact of UHC
- However, the limited impact of this narrow strategy became clear quickly, with spending on outdoor services becoming disastrous for low-income households.
- In addition, many unnecessary medical interventions were carried out, preventing access to necessary healthcare and medicines.

Firstly, India has a dual burden of communicable and non-communicable diseases, and many of these diseases are preventable through early detection, health education, timely referral, and management.
Nearly 8 lakh cancer cases are detected yearly, with 60-80% of cases being diagnosed late.
The major underlying causes of many diseases are a lack of awareness and poor health-seeking behaviour.
Inadequate healthcare quality, accessibility, and affordability.
Additionally, out-of-pocket expenses are high.
Infrastructure, equipment, and skilled labour are in short supply.
Many villages lack primary health care centres, and those with them lack basic amenities.
Almost 70% of healthcare is delivered by private players who are heavily regulated.
Sanitation, disease surveillance, political will, and public health response are all lacking.
Furthermore, the government only spends 1.5% of the GDP on public health care.

Making health a priority in all aspects of development
- Health in all policies, one health, planetary health, and pandemic preparedness are all examples of one health.
Strengthening health systems
- Creating PHC-with-UHC models for a variety of contexts.
- Conceptualised as a care continuum ranging from home self-care to community services and primary-level para-medical services.
- In addition, first contact with a doctor, with services provided as close to the home as possible, at an affordable and easily deliverable price.
Appropriate technologies that should become the norm
- Rationally strengthening health technology assessment, healthcare ethics, equitable access to pharmaceutical products and vaccines, and integrative health systems using plural knowledge systems.
Health and medical care as seen by the marginalised
- Health care needs for women, care for indigenous peoples worldwide, workplace wellness, mental health and wellbeing, and healthy ageing.

It is necessary to create PHC-with-UHC (a PHC 2.0) with wide international support and a dedication to a more enduring and humane healthcare system.
Such an agenda would require extensive international, regional, and national dialogue.
To commit to a universal, cheap, inclusive, and just healthcare system, India should use its presidency to design a model policy focusing on primary healthcare.

Pic Courtesy: freepik

Content Source: Indian Source