primary health care

 {Photo credit: MSH}A woman and her child consult with an ADDO dispenser in Tanzania.Photo credit: MSH

Cross-posted with permission from the Bill & Melinda Gates Foundation Blog, Impatient Optimists.

Primary health care has many different definitions, but can be defined simply as the first place where people seek care. Within this definition, private sector providers constitute an important source of primary health care in many parts of the world.

Private providers of primary health

Private providers can run the spectrum–from private hospitals, pharmacies, and non-profit clinics, to informal providers such as faith-based healers and drug shops. A 2013 review suggests that informal providers account for as much as two-thirds of health care visits in Bangladesh and Thailand, and a substantial percentage of visits in Nigeria and Kenya as well.[1]

Makasi after two months of tuberculosis treatment. {Photo credit: A. Massimba/MSH.}Photo credit: A. Massimba/MSH.

With less than 1000 days until the Millennium Development Goals expire, the process for setting post-2015 goals continues to ramp up.  We take this opportunity to reflect on the current state of community health systems in low- and middle-income countries and consider how the post-2015 agenda could reshape them—perhaps dramatically.

Community health systems today

Integration moves ahead

Poor and rural communities in low- and middle-income countries are leaving behind the “one clinic, one service” approach. So-called vertical programs, which organized resources according to single health conditions, created a patchwork of health services at the community level. You could get HIV care from one provider, but would have to go down the hall, down the street, or often much farther to get maternal health care or malaria care.

Dr. Stephen Macharia of MSH TB CARE I South Sudan speaking at Union World Conference symposium. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted from the MSH at the Union World Conference on Lung Health 2012 blogManagement Sciences for Health (MSH) presented at several symposia and workshops throughout the 43rd Union World Conference on Lung Health (read more).

Friday’s symposium on November 16 dealt with: Saving lives in areas of conflict or disaster: partnering for results (PDF). Dr. Eliud Wandwalo of MSH Tanzania coordinated the session along with Morgan Richardson.

Trying to cross through a flooded section of road in South Sudan. {Photo credit: E. Polich/MSH.}Photo credit: E. Polich/MSH.

“We’re going to try to drive through that?”

After spending nearly two years working in South Sudan, I was on my way with two colleagues to one final meeting. The USAID-funded second phase of the Sudan Health Transformation Project (SHTP II), led by Management Sciences for Health (MSH), ended activities on July 31, 2012, and three of us needed to travel 360 kilometers (220 miles) to a results dissemination meeting. A flight booking mishap meant we had no choice but to drive --- during rainy season.

With a key bridge washed out.

And it rained --- down poured --- for over an hour the morning we left.

After passing several toppled trucks, overtaking pickups irrevocably mired in mud, and crossing through a river, we came across the point where I uttered the above quote (“We’re going to try to drive through that?”).

Tukuls in the process of construction which will house midwives and PHCC staff, as viewed from Muni PHCC, (Muni Payam, Terekeka County, Southern Sudan)

Terekeka, a growing county and town just 60 miles north of Juba, translates as “The Forgotten” in the local dialect.  Just five years ago, this area was awash in violence, poised close to the frontlines of a civil war which resulted in the death and displacement of millions. Villagers and returnees began repopulating the area after the signing of the Comprehensive Peace Agreement in 2005, which heavily increased demand for health services. Today, Terekeka is heavily populated by southern returnees seeking refuge, land, and jobs, as well as internally displaced persons escaping nearby tribal violence.

Printer Friendly Version
Subscribe to RSS - primary health care