Policy Instrument:
Definition
Access to basic health care is the equitable and effective coverage of essential health services, whereby all individuals and populations can obtain needed high-quality preventive, promotive, curative, rehabilitative, and palliative care through health systems that ensure timely utilisation and protect users from catastrophic and impoverishing financial consequences, consistent with the universal health coverage targets under SDG 3.8 (SDG 3: Good health and well-being).
Rationale
Primary Health Care (PHC)-based systems ensure the delivery of health and social services to holistically address peoples' medical and socioeconomic needs, including food insecurity and poverty. This involves coordinating care across different levels of care, providers and sectors and the use of screening and referral systems to identify users experiencing addressing food insecurity or poverty.
PHC acts as a critical entry point to access health, nutrition, social and care services and resources. Population based screening at the territorial level can identify target populations and can through passive sociodemographic data collection upon user registration to household analysis to determine economic needs during community outreach.
In addition, PHC supports the development of community engagement mechanisms as part of integrated models of care, involving the active engagement of local communities in the definition and organization of services to address health, poverty and hunger, including through the deployment of community health workers to reach underserved populations and address social determinants of health like food insecurity and poverty.
PHC-based systems establish formal partnerships and collaboration mechanisms with other sectors (e.g. social and care services, social protection) to coordinate care for users facing hunger and poverty. And PHC, with a health financing strategy that includes financial and social protection mechanisms (elimination of out-of-pocket expenditures at the point of care, conditional cash transfers etc) can significantly improve health outcomes while alleviating poverty and hunger.
All people, especially underserved populations (living in areas where access is inadequate) and groups in situation of vulnerability (e.g., children and mothers, people living in poverty).
Prior conditions for success include strong political commitment, adequate funding, and existing intersectoral relationships, including targeting funding to ensure social and financial protection.
Limitations such as system restructuring challenges and data sharing issues must be addressed. Complementary instruments, including aligned financial incentives and robust referral systems, are crucial for effective implementation.
Potential risks range from increased provider workload to privacy concerns and unintended consequences of health and population screening. To mitigate these risks and maximize impact, implementation should be tailored to local contexts, phased appropriately, and continuously evaluated. Engaging communities in design and implementation is essential, as is maintaining a focus on equity to ensure vulnerable populations benefit. While integrating health and social services presents significant challenges, it offers a promising approach to holistically addressing the complex interplay between health and socioeconomic factors, potentially improving outcomes for individuals and communities alike.
SDG 3 - Good health and well-being
- Target 3.8 - Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.