Primary Healthcare Must be Strengthened Locally

Primary healthcare (PHC), which englobes almost all the care needs a person might need during their life, has been greatly impacted by the pandemic, according to a recent report by WB. In the “Walking the Talk: Reimagining Primary Health Care After COVID-19” report, WB explains the pathway to follow to revitalize PHC and make it more supportive and effective to overcome the current crisis.

PHC, which covers prevention, treatment, rehabilitation and palliative care, is the base of a health system’s structural transformation, according to WB. PHC entails comprehensive integrated health services that embrace primary care as well as public health goods and functions as central pieces, according to WHO. It also requires multi-sectoral policies and actions to address the wider determinants of health. Finally, to be effective PHC should engage and empower individuals, families and communities for enhanced self-care and self-reliance in health, adds the WHO.

In its report, WB points to PHC as the base of the structural transformation necessary after the health system collapsed during the pandemic. The report highlights the importance of strengthening local systems one community at the time. In Mexico, care providers are also prioritizing PHC to strengthen their care provision through innovative solutions that aim to enhance local care.

Juan Galindo, Chief Medical Officer of CHRISTUS MUGUERZA, told MBN that the hospital chain “began creating educational campaigns at primary care centers. We are now complementing these with our telemedicine platform to offer virtual care, from prevention to treatment using communication tools.” Through this communication tools, the institution aims to provide a more precise attention.

WB suggests three core reforms to the PHC model in a post-pandemic era. The first reform is the implementation of a multidisciplinary team-based care provided by PHC teams familiar with local realities. This way, proactive PHC teams can tackle barriers to care that disproportionately affect vulnerable communities. Engaging directly with communities, local teams can deliver health education and promotion, offer nutritional coaching and supplementation, identify subclinical illness, and help sustain adherence to treatment for diseases to reduce health disparities.

The second reform is the development of a multi-professional health workforce, which would help countries like Mexico that lack of specialists and nurses. The transition to community team-based care requires a reorientation of medical education, particularly for physicians. This educational shift must go beyond clinical knowledge and skills to integrating additional competences, such as strategic communication capacity to dialogue with communities about health needs.

Finally, general government revenue should be used to finance PHC and facilitate equitable access to health services. Mexico allocates US$1,154 per capita or around 5.5 percent of its GDP to healthcare, which falls below the average of the OECD that is 8.8 percent and US$4,224 dollars per capita. WB’s report highlights the difficulty of allocating resources to healthcare and encourages financing methods that prioritize investment. “These emerging models, sometimes called “value-based” payments, shift clinical and financial accountability to providers by adjusting and conditioning reimbursement based on cost, quality, and patient-experience metrics,” said the WB.