02593nas a2200433   4500000000100000008004100001260001600042653002100058100001300079700001300092700001500105700001600120700001700136700001700153700001400170700001300184700001500197700001500212700001300227700001500240700001100255700001300266700001100279700001200290700001200302700002100314700001300335700001700348700001500365700001900380700001100399700001200410245010300422856007500525300001400600490000700614520152400621022001402145       2022                            d  bElsevier BV10aGeneral Medicine1 aHanson K1 aBrikci N1 aErlangga D1 aAlebachew A1 aDe Allegri M1 aBalabanova D1 aBlecher M1 aCashin C1 aEsperato A1 aHipgrave D1 aKalisa I1 aKurowski C1 aMeng Q1 aMorgan D1 aMtei G1 aNolte E1 aOnoka C1 aPowell-Jackson T1 aRoland M1 aSadanandan R1 aStenberg K1 aVega Morales J1 aWang H1 aWurie H00aThe Lancet Global Health Commission on financing primary health care: putting people at the centre  uhttps://www.thelancet.com/action/showPdf?pii=S2214-109X%2822%2900005-5  ae715-e7720 v103 a<p>The COVID-19 pandemic has brought the need for well-functioning primary health care (PHC) into sharp focus. PHC is the best platform for providing basic health interventions (including effective management of non-communicable diseases) and essential public health functions. PHC is widely recognised as a key component of all high-performing health systems and is an essential foundation of universal health coverage.</p>

<p>PHC was famously set as a global priority in the 1978 Alma-Ata Declaration. More recently, the 2018 Astana Declaration on PHC made a similar call for universal coverage of basic health care across the life cycle, as well as essential public health functions, community engagement, and a multisectoral approach to health. Yet in most low-income and middle-income countries (LMICs), PHC is not delivering on the promises of these declarations. In many places across the globe, PHC does not meet the needs of the people—including both users and providers—who should be at its centre. Public funding for PHC is insufficient, access to PHC services remains inequitable, and patients often have to pay out of pocket to use them. A vicious cycle has undermined PHC: underfunded services are unreliable, of poor quality, and not accountable to users. Therefore, many people bypass primary health-care facilities to seek out higher-level specialist care. This action deprives PHC of funding, and the lack of resources further exacerbates the problems that have driven patients elsewhere.</p>
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