The World Health report 2008 - Primary healthcare: How wide is the gap between its agenda and implementation in 12 high-income health systems?

Robin Gauld, Robert Blank, Jako Burgers, Alan B. Cohen, Mar K. Dobrow, Nao K.I. Ikegami, Soonman Kwon, Karen Luxford, Christopher Milett, Claus Wendt

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Background: The World Health Organization's 2008 report asserted that the focus on primary healthcare (PHC) within health systems should increase, with four sets of reforms required. The WHO's PHC advocacy is well founded, yet its report is a policy document that fails to address adoption and implementation questions within WHO member countries. This paper examines the prospects for the WHO PHC agenda in 12 high-income health systems from Asia, Australasia, Europe and North America, comparing performances against the WHO agenda. Methods: A health policy specialist on each of the 12 systems sketched policy activities in each of the four areas of concern to the WHO: (a) whether there is universal coverage, (b) service delivery reforms to build a PHC-oriented system, (c) reforms integrating public health initiatives into PHC settings and (d) leadership promoting dialogue among stakeholders. Findings: All 12 systems demonstrate considerable gaps between the actual status of PHC and the WHO vision when assessed in terms of the four WHO reform dimensions, although many initiatives to enhance PHC have been implemented. Institutional arrangements pose significant barriers to PHC reform as envisioned by the WHO. Conclusions: PHC reform requires more attention from policy makers. Meanwhile, the WHO PHC report is perhaps too idealistic and fails to address the fundamentals for successful policy adoption and implementation within member countries.

Original languageEnglish
Pages (from-to)38-58
Number of pages21
JournalHealthcare Policy
Volume7
Issue number3
Publication statusPublished - 2012 Feb 1

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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    Gauld, R., Blank, R., Burgers, J., Cohen, A. B., Dobrow, M. K., Ikegami, N. K. I., Kwon, S., Luxford, K., Milett, C., & Wendt, C. (2012). The World Health report 2008 - Primary healthcare: How wide is the gap between its agenda and implementation in 12 high-income health systems? Healthcare Policy, 7(3), 38-58.