As the global community prepares to renew and refine commitments to UHC and primary health care (PHC), we have the opportunity to advocate for high-quality community health programs in realizing a PHC-driven UHC agenda. Decades of evidence indicates that community health programs can extend quality PHC services to rural and vulnerable populations since local community health workers can deliver essential health services where health facilities do not exist. Compared to traditional health delivery models, which rely solely on facility-based care, fail to prioritize vulnerable populations, and are costly for resource-constrained governments, strong community health systems offer a cost-effective solution to achieve UHC that extends care access to vulnerable populations first.
In the decades following the first declaration on PHC, the global community built a strong evidence base on the efficacy and shortcomings of community health program implementation. In order to achieve full potential, these programs must be country-owned, sustainably financed, and incorporated into national health strategies. To be effective, community health programs cannot be treated as stand-alone or vertical programs; rather, they must be integrated into the national PHC system. These programs should also be included in national health strategies to increase access and provide services aligned to population needs and locations.
MEASURING COMMUNITY HEALTH
At the 2019 High-Level Meeting on UHC (HLM-UHC), national governments will come together to report on progress and identify challenges in achieving UHC. Without a global commitment to country-owned, integrated community health systems that prioritize access for vulnerable, rural populations, UHC will be impossible to achieve. We must call for inclusion of community-based primary care as a priority in country reports and other HLM-UHC key documents to ensure success overall.
Following the 2018 Primary Health Care Conference in Astana, Kazakhstan, the recent launch of WHO’s community health worker (CHW) guidelines and the upcoming High-Level Meeting on UHC in September 2019, there is a global momentum for community health. Our global workstream works towards ensuring the sustainability of this global momentum by integrating community health as a priority in global UHC strategies and key documents. At the same time, we believe now is the time to translate this global momentum into local change and follow up on commitments made in global spaces around community health. Our national workstream calls upon national governments to include community health as a priority in their country reports to be delivered at the HLM-UHC. Furthermore, we track progress made related to integrating community health in national health strategies and policies as well as in national UHC strategies.
Our long-term objectives for the campaign at the country level will begin with collecting baseline information on the status of community health across domains . We will develop country-specific long-term objectives for each target country.