World Vision International
World Vision fully supports the Declaration of Astana, and we appreciate the renewed prioritization of primary health care as a foundational pre-requisite towards achievement of universal health coverage. It is clear today that primary health care investments improve population health outcomes and are cost effective.
However, our health systems remain predominantly clinical, tertiary, and under-funded. It is likely we will not realize effectively scaled primary health care systems until we can 1) better identify the right resource allocation balances between tertiary and primary investments, and 2) gradually increase the proportion of primary health care investment.
We would like to highlight two foundational requirements for achieving primary health care. First, people-centered health systems must consistently and systematically promote public participation and accountability. Routine measures should be employed to inform the public on their health status, national policy, rights, and investment. The public should be regularly involved in progress monitoring, policy development and resource allocation prioritization.
Second, to address health determinants, the health community must recognize that multi-sector coordination is imperative to tackle issues like malnutrition, violence, early child development, and non-communicable diseases. This coordination, requiring greater competency in collective action, is critical to comprehensively and strategically address these issues, as well as to attain the objectives of achievable plans through cost and resource-sharing. We therefore call for the development of integrated, horizontal health strategies, and investment into the non-traditional planning and coordination competencies needed to achieve them.