Tackling the primary care access challenge in South Asia

Well designed and accessible primary care reduces the need for hospital based care and contributes to better overall health. Despite a large network of primary care facilities, large sections of the population in South Asia lack access to reliable and effective primary care. This is reflected in poor health indicators across the region.1 The 2015 Human Development Report found that five of six South Asian nations (India, Nepal, Bangladesh, Pakistan, and Afghanistan) have higher mortality rates among under 5s and adults, greater prevalence of child malnutrition, higher mortality rates from tuberculosis, and lower life expectancy at 60 years compared with the global average.2 Deficiencies in public funded primary health services have contributed to rapid expansion of private providers in the region. The growth of the private sector has largely been determined by market forces with minimal oversight and regulation, and there are concerns about both the quality and the cost of care. In this paper we reflect on the challenges of primary care in the region, the opportunities it poses, and the implications for public policy.