As countries increase public spending on health, strengthening primary health care systems and progress toward universal health coverage improves. Governments of low- and middle-income countries must spend at least five percent of their GDP on primary health care by 2025.
One way that countries can improve primary health care systems is through rights-based packages of quality essential health-care services. These packages are country-defined priorities for improving equitable health care delivery as well as providing access to one or more essential health services for at least half of the world’s population.
A strong primary health care system is the cornerstone of every country’s health system—and a first step toward achieving universal health coverage. A primary health systems approach is people-centered, which includes preventative and community health services.
Underpinned by the promise of equity, quality and access, universal health coverage (UHC) means that all people and communities can use the essential promotive, preventive, diagnosis, treatment, rehabilitative and palliative health services they need, of sufficient quality, without risk of financial hardship. The commitment to UHC is enshrined in the Sustainable Development Goals.
100 million people in low- and middle-income countries are being pushed into poverty because of out-of-pocket spending on health. Although user fees are a method for revenue generation and cost containment in the health system, individuals often pay more than their fair share.
The principle of pro-poor universalism refers to the gradual progression toward full universal health coverage with a focus on disadvantaged groups—allowing for the poorest and most vulnerable to gain access first, in an equitable way. Prioritizing the poor is the most effective mechanism for improving coverage.
Essential health services typically delivered through primary health care systems should be universally available for everyone and not dependent on people’s abilities to pay or where they live.
PHC services should be universally available for everyone, adhering to the principle leave no one behind. This includes those who are marginalized due to poverty, ethnicity, age, disability, gender, sexual orientation, gender identity, religion, migration status, conflict, distance, remoteness and key populations.
Integrated, effective, people-centered essential health services form the foundation of quality primary health care. Community perspectives and needs should be the driving force when evaluating quality.