An unfinished agenda
Insights from seven country case studies on strengthening primary health care in the Western Pacific Region
Bibliographic Data
| ID | 21878914 |
|---|---|
| Authors | Alexandra Edelman (0000-0002-2021-5266, Charles Darwin University), Lluis Vinyals Torres (0000-0002-0369-6969, World Health Organization Regional Office for the Western Pacific), Anis Kazi (World Health Organization Regional Office for the Western Pacific), Kumanan Rasanathan (0000-0001-9347-1765, World Health Organization), Rainer Martens (0000-0002-2416-2309, World Health Organization) |
| Year | 2025 |
| Volume | 10 |
| Issue | Suppl 2 |
| Pages | e017442 |
| Publication date | 2025-04-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-017442 |
| PMID | 40174966 |
| OpenAlex | W4409087954 |
| Language | EN |
| Citations received | 4 |
| References cited | 22 |
In the WHO Western Pacific Region, primary health care (PHC) is considered ‘the future of health’ and the key to achieving universal health coverage. However, political, economic and social forces underlying curative, hospital-centric models have eroded public, local-level health service capacity—contributing to fragmented systems and persisting health inequities. Drawing insights from seven published country case studies from East Asia examining PHC in the context of the COVID-19 pandemic, this paper discusses key factors influencing the implementation of PHC. Countries are improving service delivery through a PHC approach, but persisting governance and structural barriers to PHC reform include vertical approaches to health care planning and programme delivery, health workforce shortages and maldistribution, and market forces that have shaped health care and workforce models towards curative care. Three domains for future policy and research to strengthen PHC are proposed. First, managing the political economy of PHC reform requires mapping relationships and systematically unravelling political, social and economic factors shaping accountability, receptiveness and capacity for change. Second, strengthening participatory governance involves shifting power to communities through platforms for shared policy creation and implementation, decentralised governance and empowering community-oriented health workers. Third, improving conceptual clarity and policy guidance on PHC can use the Sustainable Development Goals to orient systems towards preventing illness and valuing good health. The case studies offer a practice model of applied health policy and systems research coproduced with policy stakeholders
Accountability · Business · CLARITY · Corporate governance · Economic growth · Economics · Health care · Political science · Public health · Service delivery framework · Social determinants of health · Workforce · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Primary Care and Health Outcomes · Health Policy
Revisiting Alma-Ata
The Lancet Global Health Commission on financing primary health care
The application of systems thinking in health
The 2018 Astana Declaration on Primary Health Care, is it useful
Modified scoping review of the enablers and barriers to implementing primary health care in the Covid-19 context
Political economy analysis of health financing reforms in times of crisis
The political economy of health financing reform in Malaysia
| Unique citing works | 4 |
|---|---|
| Citations per year | 4 |
| Citation span | 2025 - 2026 (2) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 4 |