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      Learning by Doing: Accelerate Towards the NCD Target in SDG Through Primary Healthcare Comment on "Universal Health Coverage for Non-communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

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          Abstract

          Health systems built on the foundation of primary healthcare (PHC) are essential to achieve universal health coverage (UHC). To adequately respond to the needs of people with non-communicable diseases (NCDs) and enable optimal management in primary care settings, changes are needed at many levels. PHC levers recommended in the UHC framework as the cornerstone of achieving Sustainable Development Goal (SDG) goals by strengthening the primary care system include strategic and operational levers. Experience from hypertension control programs across 18 countries has shown that rapid scale-up can be achieved through systematic improvement of the PHC system brought about by political commitment, financial support, and high-quality people-centred primary care. As countries are gripped with the pandemic the importance of an appropriate and resilient health system fit for the country is emerging as a priority for building preparedness. While there are general principles, each country must learn by doing and scale up models relevant to the national context.

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          Better health and wellbeing for billion more people: integrating non-communicable diseases in primary care

          Cherian Varghese and colleagues describe a model to improve equitable access to good quality health services for non-communicable diseases within primary healthcare
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            Reinventing primary health care: the need for systems integration.

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              Universal Health Coverage for Non-communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare

              Background: Universal health coverage (UHC) is central to current international debate on health policy. The primary healthcare (PHC) system is crucial to achieving UHC, in order to address the rising incidence of non-communicable diseases (NCDs) more effectively and equitably. In this paper, we examine the Australian case as a mature system of UHC and identify lessons for UHC policy to support equity of access to PHC and reduce NCDs. Methods: Our qualitative research used policy mapping and monitoring and 30 key informant interviews, and applied policy theory, to investigate the implementation of Australian PHC policy between 2008 and 2018. Results: Although the Australian PHC system does support equity of access to primary medical care, other ideational, actor-centred and structural features of policy detract from the capacities of the system to prevent and manage NCDs effectively, deliver equity of access according to need, and support equity in health outcomes. These features include a dominant focus on episodic primary medical care, which is a poor model of care for NCDs, and an inequitable distribution of these services. Also, a mixed system of public and private insurance coverage in PHC contributes to inequities in access and health outcomes, driving additional NCD demand into the health system. Conclusion: Countries aiming to achieve UHC to support health equity and reduce NCDs can learn from strengths and weaknesses in the Australian system. We recommend a range of ideational, actor-centred and structural features of UHC systems in PHC that will support effective action on NCDs, equity of access to care according to need, and equity in health outcomes across geographically and ethnically diverse populations.
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                Author and article information

                Journal
                Int J Health Policy Manag
                Int J Health Policy Manag
                Kerman University of Medical Sciences
                International Journal of Health Policy and Management
                Kerman University of Medical Sciences
                2322-5939
                May 2022
                21 August 2021
                : 11
                : 5
                : 708-710
                Affiliations
                1Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.
                2Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
                Author notes
                [* ]Correspondence to: Cherian Varghese Email: varghesec@ 123456who.int
                Author information
                https://orcid.org/0000-0001-6907-0451
                Article
                10.34172/ijhpm.2021.96
                9309936
                34634875
                31997756-8018-497f-acb7-1a7aaf21ee8f
                © 2022 The Author(s); Published by Kerman University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 May 2021
                : 28 July 2021
                Page count
                References: 11, Pages: 3
                Categories
                Commentary

                non-communicable diseases,primary healthcare,sustainable development goals,local solutions

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