Priorities for primary health care policy implementation: recommendations from the combined experience of six countries in the Asia–Pacific
Ryuki Kassai A Q , Chris van Weel B C , Karen Flegg D , Seng Fah Tong E , Tin Myo Han F , Sairat Noknoy G , Myagmartseren Dashtseren H , Pham Le An I J , Chirk Jenn Ng K , Ee Ming Khoo K , Kamaliah Mohd Noh L , Meng-Chih Lee M N , Amanda Howe O and Felicity Goodyear-Smith PA Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima 960-1295. Japan.
B Department of Primary and Community Care, Radboud University Medical Center, 117-ELG, PO Box 9101, 6500HB Nijmegen, The Netherlands.
C Department of Health Services Research and Policy, Australian National University, 63A Eggleston Road, Acton, ACT 2601, Australia.
D World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), 12A-05 Chartered Square Building, 152 North Sathon Road, Silom, Bangrak, Bangkok 10500, Thailand.
E Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
F Myanmar General Practitioners Society, No. 246, Theinbu Road, Mingalar Taung Nyunt Township, Yangon 11221, Myanmar.
G The Royal College of Family Physicians of Thailand, 11th Floor, The Royal Golden Jubilee Building, New Petchaburi 47 Road, Bangkapi, Bangkok 10310, Thailand.
H Department of Family Medicine, Mongolian National University of Medical Sciences, Zorig Street, POB 48/111, Ulaanbaatar 14210, Mongolia.
I Family Medicine Training Center, University of Medicine and Pharmacy, 217 Hong Bang Street, District 5, Ho Chi Minh City 700000, Vietnam.
J Vietnamese Association Family Physician, 217 Hong Bang Street, District 5, Ho Chi Minh City 700000, Vietnam.
K Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Jalan Lembah Pantai, 50603 Kuala Lumpur, Malaysia.
L Cyberjaya University College of Medical Sciences, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia.
M Institute of Medicine, Chung Shan Medical University, 110 Section 1, Chien Kuo North Road, Taichung 40201, Taiwan.
N Institute of Population Health Sciences, National Health Research Institutes, Miaoli, 35 Keyan Road, Zhunan, Miaoli County 35053, Taiwan.
O Health Services and Primary Care, Norwich Medical School, University of East Anglia, Norwich Research Park, Earlham Road, Norwich, Norfolk NR4 7TJ, UK.
P Department of General Practice and Primary Health Care, University of Auckland, PB 92 019, Auckland 1142, New Zealand.
Q Corresponding author. Email: ryukikas@fmu.ac.jp
Australian Journal of Primary Health 26(5) 351-357 https://doi.org/10.1071/PY19194
Submitted: 9 October 2019 Accepted: 31 March 2020 Published: 4 August 2020
Journal Compilation © La Trobe University 2020 Open Access CC BY-NC-ND
Abstract
Primary health care is essential for equitable, cost-effective and sustainable health care. It is the cornerstone to achieving universal health coverage against a backdrop of rising health expenditure and aging populations. Implementing strong primary health care requires grassroots understanding of health system performance. Comparing successes and barriers between countries may help identify mutual challenges and possible solutions. This paper compares and analyses primary health care policy in Australia, Malaysia, Mongolia, Myanmar, Thailand and Vietnam. Data were collected at the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Asia–Pacific regional conference in November 2017 using a predetermined framework. The six countries varied in maturity of their primary health care systems, including the extent to which family doctors contribute to care delivery. Challenges included an insufficient trained and competent workforce, particularly in rural and remote communities, and deficits in coordination within primary health care, as well as between primary and secondary care. Asia–Pacific regional policy needs to: (1) focus on better collaboration between public and private sectors; (2) take a structured approach to information sharing by bridging gaps in technology, health literacy and interprofessional working; (3) build systems that can evaluate and improve quality of care; and (4) promote community-based, high-quality training programs.
Additional keywords: family doctor, general practice, global health, international collaboration, social determinants of health, universal health coverage.
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