Intended for healthcare professionals


Expanding primary care in South and East Asia

BMJ 2017; 356 doi: (Published 27 February 2017) Cite this as: BMJ 2017;356:j634
  1. Chris van Weel, emeritus professor of general practice1 2,
  2. Ryuki Kassai, professor of family medicine3
  1. 1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
  2. 2Department of Health Services Research and Policy, Australian National University, Canberra, Australia
  3. 3Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan
  1. Correspondence to: C van Weel chris.vanweel{at}

Chris van Weel and Ryuki Kassai look at efforts to strengthen primary care and call for regional and international collaboration to help implement policy

More than 60% of the world population live in Asia, with substantial numbers in very deprived socioeconomic conditions. The heterogeneity between the countries of the region is reflected in their health systems, which vary from well developed to virtually absent. Providing access to care, in particular for those at greatest need, is a regional priority1 that comes on top the more general global challenge of transforming health systems to respond better to the needs of ageing populations with chronic health problems and increasing health costs.2

Health systems based on primary care have been shown to achieve better equity and better population health at lower costs.345 Patients with chronic conditions in countries with strong primary healthcare are more likely to be in good or very good health than those in countries with less well developed primary care.6 The same is true for frail patients with multiple chronic conditions.789 This evidence has led to a global strategy to strengthen primary care,1011 focusing on introducing comprehensive, continuity of care in a person and population centred approach1213 under prevailing local conditions.14

Primary healthcare has to be built from the community where it has to operate, so knowledge of population needs and the existing health system is important in initiating reforms. However, most of the available experience and insight come from Europe and North America,1516 with data for many other many countries and regions, including South and East Asia scarce.17 The World Organisation of Family Doctors (WONCA) therefore took the initiative to document how primary care is organised around the world and to create …

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