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Primary healthcare policy implementation in South Asia
  1. Chris van Weel1,2,
  2. Ryuki Kassai3,
  3. Waris Qidwai4,
  4. Raman Kumar5,
  5. Kanu Bala6,
  6. Pramendra Prasad Gupta7,
  7. Ruvaiz Haniffa8,
  8. Neelamani Rajapaksa Hewageegana9,
  9. Thusara Ranasinghe10,
  10. Michael Kidd11,
  11. Amanda Howe12
  1. 1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
  2. 2Division of Health Services Research and Policy, Research School of Population Health, Australian National University, Acton, Australian Capital Territory, Australia
  3. 3Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan
  4. 4Department of Family Medicine Service Line Family Health, Aga Khan University, Karachi, Pakistan
  5. 5Academy of Family Physicians of India, New Delhi, India
  6. 6Bangladesh Institute of Family Medicine & Research, University of Science & Technology Chittagong, Hatirpool, Dhaka, Bangladesh
  7. 7Department of General Practice and Emergency Medicine, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
  8. 8College of General Practitioners of Sri Lanka, Colombo, Sri Lanka
  9. 9Ministry of Health, Colombo, Sri Lanka
  10. 10WHO Country Office, Colombo, Sri Lanka
  11. 11Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  12. 12Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
  1. Correspondence to Professor Chris van Weel; chris.vanweel{at}


Primary healthcare is considered an essential feature of health systems to secure population health and contain costs of healthcare while universal health coverage forms a key to secure access to care. This paper is based on a workshop at the 2016 World Organization of Family Doctors (WONCA) South Asia regional conference, where the health systems of Bangladesh, India, Nepal, Pakistan and Sri Lanka were presented in relation to their provision of primary healthcare. The five countries have in recent years improved the health of their populations, but currently face the challenges of non-communicable diseases and ageing populations. Primary healthcare should be a core component in restructuring health systems. However, there is a lack of understanding among policymakers of the unique contribution of primary healthcare to the health of populations. This results in insufficient investment in facilities and low priority of specialty training in the community setting. Regional collaboration could strengthen the advocacy for primary healthcare to policymakers and other stakeholders. Priorities were investment in community-based health facilities, and access to healthcare through professionals specialty-trained in the primary healthcare setting. This development fits the strategy of the WHO South East Asian Region to use community-based healthcare in achieving universal health coverage for the Asian populations.

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