This blog is part of a series of blogs written by participants at HSR 2022 reflecting on some of the key messages and learnings emerging from the symposium.
Engagement with HSR 2022: The Seventh symposium on Health Systems Research in Bogota ended successfully on November 4. However, there are thoughts and memories that I shall carry along for next a couple weeks.
Before coming to the conference, I had questions in my mind as “What’s the impact of Covid-19 to the broader primary health care systems? Is there any sustainable financing strategy for vaccination?”
Within these limited days in beautiful and cold Bogota, I am not sure that I found the satisfactory answers or solutions to all those questions. Nonetheless, I would say, the conference itself was quite thought-provoking and I would want to share some of the brilliant quotes that I had heard.
One speaker said “Healthcare is a social right, and thus, democratization of health is essential for sustainable PHC delivery” which is so true and I could not agree more.
One panelist also said “Trust is an important factor for the successful engagement with the private sector. Rules of engagement with the private sectors are still not clear both in terms of accountability and equity.”
I wonder how those rules are mutually acceptable and there would be the roles of government to define carrots and sticks for the private sector motivation in mixed health systems.
Stronger together: There was a session I particularly enjoyed for receiving answers to some of my pre-conference questions. The presentations and discussions by scholars and practitioners from China, Myanmar, Thailand, and the United Kingdom in that organized session contributed to the knowledge base for innovations and lessons learnt in strengthening primary healthcare (PHC) during the COVID-19 pandemic. They highlighted the important role of PHC which has been considered the foundation of universal health coverage (UHC) and health system resilience. We all knew that the pandemic has not ended yet and during the conference I have learned how the innovative means have been done so far in preserving and strengthening PHC during the difficult times in diverse countries.
Country experiences: Chinese experience demonstrated the role of PHC in COVID-19 testing, triage, diagnosis, contact tracing, home-based monitoring and vaccine delivery. It has been observed globally that increased utilization of COVID-19 services made reduction in other primary health care services such as mental health care in Australia and cancer screenings put on hold in Canada. There were significant improvements on the use of technology in PHC for remote consultations, electronic prescriptions, electronic referral procedures, online signposting, digital monitoring and symptom self-checking. Task shifting in PHC were seen by the increased workforce of volunteers, community health workers and military staff. The workload and demand of health workers were significantly increased resulted in chronic stress, anxiety and fear among them over the possibility of contracting the virus. There is still much to learn closely to China’s zero COVID strategy over the long-term economic and social impacts.
UK experience demonstrated the need for rapid policy formulation to integrate care homes in PHC system as the large number of deaths in care homes in the early waves of COVID-19. In some countries, COVID-19 pandemic has been exacerbated by a political crisis or another double burden. There have been about 17,000 conflict events after the military takeover in Myanmar started in February 2021 resulting the displacement of over 1.4 million population and insufficient public health sector. Private and community health sectors have played an important role in addressing severe challenges to cope with population needs during these harsh times and preserved the PHC services.
With full population coverage for UHC and 1 million village health volunteers, Thailand also was no exception impacted by Covid-19 waves. However, the strong leadership, governance and health systems foundation prevented the overwhelming of public health systems and resulted the fewer casualties of Covid-19 deaths even compared to the developed world.
Unsung heroes: Last but not the least, I greatly acknowledge the effort of health sectors and health care workers for their tireless contribution to save countless lives and here, I would like to express my deepest gratitude to the our colleagues whom we had lost while providing essential health services during the pandemic.
By Dr. Han Win Htat, Executive Director, Sun Community Health.