Problems in primary care: A global perspective

Abstract

Primary care is widely recognised as the cornerstone of health systems, but many countries have overlooked primary care and important evidence of the efficacy of primary care services in delivering better healthcare, better health outcomes and reduced health inequalities. Evidence shows health is better in areas with more primary care doctors and people receiving care from primary care doctors are healthier. This article explores problems with the systems of primary care from a global perspective. We focus on four regions (Africa, East Mediterranean, Western Pacific and South Asia) and select countries within these regions. In this article, we use the term primary care to refer to ‘the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.’ The term primary health care is employed interchangeably throughout this article, although we acknowledge this is a much broader term derived from core principles articulated by the World Health Organisation and including services delivered to individuals and their communities (primary care services) and population-level ‘public health-type’ functions.