Primary Health Care
A beginner seeking to understand primary health care could perhaps start with the excellent section on its meaning in the World Health Report of year 2008.
From this collective we begin with a much more contemporary and recent introduction to this theme with the guide-book : Understanding Comprehensive Primary Health Care: The Meghalaya Way. Published in Nov 2022 by National Health Mission, this book was collectively written by a team from CPR, and govt of Meghalaya. This introduction is written for the primary health care providers themselves and for district level teams.
This Ayushman Bharat- Health and Wellness Scheme on which the Meghalaya model is based on the Report of a Task Force to Roll Out Comprehensive Primary Health Care – published by Ministry in the year 2016. This report sets out the conceptual basis of this scheme.
This report itself was part of implementing the mandate to shift from selective primary health care to comprehensive health care as adopted in the National Health Policy 2017. The chronology is confusing, since the operational recommendations pre-ceeded the policy adoption. That happened due to delays in finalization of the National Health Policy due to a discussion on some other aspects. But noting the consensus on this part of the policy- work on the roll-out started earlier.
One of the sources that supported the National Health Policy, or at least some of those worked on the draft was this e-Book: “Archetypes of Inclusive Healthcare: Where Healthcare for the Poor is not Poor Healthcare” . This is a collection of 16 case studies with contributions from over 15 colleagues, It has an introductory and concluding chapter that sets outs the learnings from these case studies for building equitable health systems with emphasis on primary health care. Not all of these are success stories- we also look at examples of what did not work. This collection of case studies was done with assistance from WHO India. WHO office took the lead in presenting these findings as a brief peer reviewed journal paper: “What makes primary healthcare facilities functional, and increases the utilization? Learnings from 12 case studies.” (Lahariya C, Sundararaman T, Ved R, Adithyan GS et al) ,But we would advise the reader to read the full E-book to get the full story.
If your interest is in the politics of primary health care and Health For All then a great publication to start with will be the year 2000 publication by the emerging peoples health movement called “Whatever Happened to Health for All by 2000 AD.” The first draft and subsequent edits of the entire set of 5 publications published for that campaign, were developed through a very participatory process. We note that the lead author for this series and for this web-resource are the same. The rest of the series is also put up and linked to appropriate headings.
Being currently an India-centric collective, we do not have much work to share of global studies- but two interesting articles that we are involved in are: “Tackling the primary care access challenge in South Asia:” Amit Sengupta; Shehla Zaidi, T Sundararaman, Sharad Onta et al” and “Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions“. This paper does not quite do justice to the richness of the discussion at the workshop organized at Bellagio by David Sanders and Chan Swanson, to elucidate the essential features of building equitable health systems- but still it is interesting to document it. The workshop brought together activists, practitioners and academics to discuss approaches to strengthening health systems.