International Journal of Nutrition, Pharmacology, Neurological Diseases

: 2018  |  Volume : 8  |  Issue : 1  |  Page : 1--2

Primary Health Care to Conserve the Access to Health Care for the Marginalized Communities of the Developing World

Mainul Haque 
 Faculty of Medicine and Defence Health, National Defence University of , Kem Sungai Besi, Kuala Lumpur, Malaysia

Correspondence Address:
Mainul Haque
Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Sungai Besi, 57000-Kuala Lumpur

How to cite this article:
Haque M. Primary Health Care to Conserve the Access to Health Care for the Marginalized Communities of the Developing World.Int J Nutr Pharmacol Neurol Dis 2018;8:1-2

How to cite this URL:
Haque M. Primary Health Care to Conserve the Access to Health Care for the Marginalized Communities of the Developing World. Int J Nutr Pharmacol Neurol Dis [serial online] 2018 [cited 2018 Feb 18 ];8:1-2
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Full Text

In many countries, globalization is increasingly causing stress regarding the social bondage, and health systems, as the key constituents of the architecture of contemporary societies, are clearly not performing as well as they could and as they should.[1] People are more and more intolerant with the incapability of health services.[1] Furthermore, health is considered as an indispensable state for their accomplishment, and the highest possible attainment of health is a fundamental right of every human being without distinction of any kind and is defined as complete physical, mental, and social well-being, not merely negatively as the absence of disease or infirmity.[2] It is well known that primary health care (PHC) persuades toward more appropriate and useful health upshot, lower expenses, and greater egalitarianism in health,[3],[4] and an imperative part of a nation’s development should be the strengthening of primary healthcare services.[5],[6] PHC is typically the first place where any individual goes, often to a general or family physician, when she/he has any health issues. PHC classically comprises routine care, care for urgent but minor or common health problems, mental health care, maternity and child care, psychosocial services, liaison with home care, health promotion and disease prevention, nutrition counseling, and end of life care.[7] PHC is also imperative for chronic disease prevention and management and may include other health professionals such as nurses, nurse practitioners, dietitians, physiotherapists, and social workers.[8] Marginalized people of developing countries are likely to have less right to use the health services than those of developed nations, and within countries, the poor have reduced access to the health services.[9] Even operational healthcare programs of developing countries were often poorly utilized,[10] and income, race, and ethnicity-related inequalities were active issues at large.[11],[12],[13],[14] PHC has been documented as a central element of active and operational health systems since the early part of the 20th century.[4],[15],[16] As PHC ensures individual and population health, thereafter, transmutes and renovates healthcare system as the heart of an integrated, people-centered health care system.[4],[17] However, regardless of the outstanding progress, especially in Estonia, Latvia, Lithuania, and Cuba, there remains a large gap between what individuals and communities need and the quality and effectiveness of care delivered.[3],[18],[19],[20],[21] Although some people of the advance world enjoys purposeful health status and the highest life expectancy in the world such as Australia, nonetheless, rural and remote peoples experience poorer health aftermaths as paralleled with many of economically deprived large city dwellers.[22] It has been observed that far-away and countryside communities had the highest rate of potentially preventable diseases and avoidable hospitalizations.[22] It was also reported that mortality rate was statistically significantly higher in those very inaccessible parts of Australia equated with most important metropolises.[23],[24] Yet again, mortality rates are conceivably the best possible marker for denoting the health status of any population.[25] World Health Organization has identified five key elements to achieving that goal of PHC: reducing exclusion and social disparities in health; organizing health services around people’s needs and expectations; integrating health into all sectors; pursuing collaborative models of policy dialogue; and increasing stakeholder participation.[26] PHC founded based on the theoretical and practical issues of health care, thereafter, are able to address the uncountable issues.[27] Moreover, PHC has been established on sound scientific demand of public health. It is equipped in such a way that it not only resolves all national public health issues but also the basic health services.[24] PHC is highly reinforced with ultimate human rights by reducing segregation and social inequalities in health.[26],[28] Awareness about health care is the primary objective of improving and strengthening PHC.[29] Furthermore, it has been suggested that the ongoing educational and motivational intervention program for all levels of health workforces are important to maximize PHC.[30] It was also suggested that improvement of structural facility and environment alongside effective systematic monitoring and evaluation exercises will promote PHC.[30],[31] Last but not the least, the trade-related intellectual property rights (TRIPS) may frequently endanger access to health services.[32] However, the viewpoints of PHC and its policy of the right to achieve the highest standard of health care for an individual or communities offer an outline through which access to fundamental human needs can be petitioned and necessary outcome be achieved.[33] The Universal Declaration of Human Rights of 1948 is clearly implanted in the archetypal PHC and, if utilized befittingly, can come across inequities affecting access to health care and medicine.[34]

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Conflicts of interest

There are no conflicts of interest.


1World Health Organization. Primary Health Care Now More Than Ever. The World Health Report 2008. Geneva, Switzerland: WHO Press, World Health Organization. Available from: [Last accessed on 2017 Oct 19].
2Grad FP. The preamble of the constitution of the World Health Organization. Bull World Health Organ 2002;80:981-4.
3Starfield B. Primary care and health. A cross-national comparison. JAMA 1991;266:2268-71.
4Bitton A, Ratcliffe HL, Veillard JH, Kress DH, Barkley S, Kimball M et al. Primary health care as a foundation for strengthening health systems in low- and middle-income countries. J Gen Intern Med 2017;32:566-71.
5Demaio AR, Nielsen KK, Tersbøl BP, Kallestrup P, Meyrowitsch DW. Primary health care: A strategic framework for the prevention and control of chronic non-communicable disease. Glob Health Action 2014;7:10.
6Adeleye OA, Ofili AN. Strengthening intersectoral collaboration for primary health care in developing countries: Can the health sector play broader roles? J Environ Public Health 2010;2010:272896.
7Primary Health Care Advisory Committee (PHCAC). Our Health Our Future. Improving Access and Delivery of Primary Health Care Services in New Brunswick. Discussion Paper. New Brunswick; 2010. Available from: [Last accessed on 2017 Oct 19].
8Canadian Institute for Health Information. Analysis in Brief. Taking Health Information Further. Experiences with Primary Health Care in Canada; 2009. Available from: [Last accessed on 2017 Oct 19].
9Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH. Poverty and access to health care in developing countries. Ann N Y Acad Sci 2008;1136:161-71.
10O’Donnell O. Access to health care in developing countries: Breaking down demand side barriers. Cad Saude Publica 2007;23:2820–34.
11National Research Council (US) Panel on Race, Ethnicity, and Health in Later Life. Critical perspectives on racial and ethnic differences in health in late life. In: Anderson NB, Bulatao RA, Cohen B, editors. Race/Ethnicity, Socioeconomic Status, and Health. Washington (DC): National Academies Press (US); 2004. Available from: [Last accessed on 2017 Oct 19].
12Escarce JJ, Kapur K. Access to and quality of health care. In: National Research Council (US) Panel on Hispanics in the United States, Tienda M, Mitchell F, editors. Hispanics and the Future of America. Washington (DC): National Academies Press (US); 2006. Available from: [Last accessed on 2017 Oct 19].
13Adepoju OE, Preston MA, Gonzales G. Health care disparities in the post-affordable care act era. Am J Public Health 2015;105:S665-7.
14Kim C, Sinco B, Kieffer EA. Racial and ethnic variation in access to health care, provision of health care services, and ratings of health among women with histories of gestational diabetes mellitus. Diabetes Care 2007;30:1459-65.
15World Health Organization (WHO). Everybody Business: Strengthening Health Systems to Improve Health Outcomes: WHO’s Framework. Geneva, Switzerland: WHO Press, World Health Organization; 2007. Available from: [Last accessed on 2017 Oct 19].
16Du Toit R, Faal HB, Etya’ale D, Wiafe B, Mason I, Graham R et al. Evidence for integrating eye health into primary health care in Africa: A health system strengthening approach. BMC Health Serv Res 2013;13:102.
17Suter E, Oelke ND, Adair CE, Armitage GD. Ten key principles for successful health systems integration. Healthc Q 2009;13:16-23.
18Polluste K, Kalda R, Lember M. Evaluation of primary health care reform in Estonia. Croat Med J 2004;45:582-7.
19Põlluste K, Kasiulevičius V, Veide S, Kringos DS, Boerma W, Lember M. Primary care in Baltic countries: A comparison of progress and present systems. Health Policy 2013;109:122-30.
20Keck CW, Reed GA. The curious case of Cuba. Am J Public Health 2012;102:e13-22.
21Reed G. Cuba’s primary health care revolution: 30 years on. Bull World Health Organ 2008;86:327-9.
22Australian Institute of Health and Welfare (AIHW). Rural, Regional and Remote Health: Indicators of Health Status and Determinants of Health, Rural Health Series Number 9, Contract No. 9. Cat. No. PHE 97. Canberra: AIHW; 2008. Available from: [Last accessed on 2017 Oct 20].
23COAG Reform Council. Healthcare 2010-11: Comparing Outcomes by Remoteness. Sydney: COAG Reform Council; 2012.
24Thomas SL, Wakerman J, Humphreys JS. Ensuring equity of access to primary health care in rural and remote Australia − What core services should be locally available? Int J Equity Health 2015;14:111.
25Robine JM, Romieu I, Cambois E. Health expectancy indicators. Bull World Health Organ 1999;77:181-5.
26World Health Organization. Primary Health Care; 2017. Available from: [Last accessed on 2017 Oct 19].
27Sambala EZ, Sapsed S, Mkandawire ML. Role of primary health care in ensuring access to medicines. Croat Med J 2010;51:181-90.
28WHO. Declaration of Alma-Ata − International Conference on Primary Health Care. Alma-Ata: September 6–12, 1978. Available from: [Last accessed on 2010 Jun 8].
29Kumar P. How to strengthen primary health care. J Fam Med Prim Care 2016;5:543-6.
30Novignon J, Nonvignon J. Improving primary health care facility performance in Ghana: Efficiency analysis and fiscal space implications. BMC Health Serv Res 2017;17:399.
31Loevinsohn BP, Guerrero ET, Gregorio SP. Improving primary health care through systematic supervision: A controlled field trial. Health Policy Plan 1995;10:144-53.
32Chaifetz S, Chokshi DA, Rajkumar R, Scales D, Benkler Y. Closing the access gap for health innovations: An open licensing proposal for universities. Global Health 2007;3:1-7.
33United Nations. The United Nations International Covenant on Economic, Social and Cultural Rights. Resolution 2200A (XXI); 1966. Available from: [Last accessed on 2017 Oct 19].
34United Nations. Universal Declaration of Human Rights. Resolution 217 A (III); 1948. Available from: [Last accessed on 2017 Oct 19].