Strong primary health care underpins the global response to NCDs

“Primary healthcare is the most frequent entry point for people to the health system and therefore offers the greatest potential to detect high-risk individuals who may be visiting health services for other health reasons … Primary health care represents a feasible, affordable, and equitable option for reaching people in need of healthcare for NCDs.”

As the first stop for basic health services, affordable and accessible primary health care is a critical element in combating NCDs and improving overall health. Health professionals stress the importance of building NCD awareness, detection, diagnosis, and early treatment capabilities within primary care centers, but also acknowledge that in many LMICs primary care infrastructure is stretched and inadequate. Survey respondents highlighted the success of focusing on primary care in the fight against infectious diseases and suggest the NCD community can leverage these lessons and capacities to confront NCDs.

— WHO Management of Noncommunicable Diseases in Primary Health Care

Leveraging established systems

“Communities in LMICs have managed to be very successful in the area of diagnosis of HIV and TB. Community health workers have developed communication and community expertise that could be leveraged in the field of NCDs. We have to be serious in understanding where these pockets of knowledge exist in order to actually build upon them … When you send healthcare workers to the house of the patients for testing of HIV, why not also test for high blood pressure and glucose levels? The moment that connection exists because of the community proximity, it should be leveraged beyond the traditional program that typically targets malaria, HIV, and TB. These programs are relatively well-funded, but they only cover infectious diseases. You can do so much more with that interaction.”

— Arnaud Bernaert,

Senior Director of Global

Health and Healthcare

World Economic Forum

Primary health care must be reoriented towards chronic care. This can be done readily in settings where HIV chronic care platforms have been established, as these provide an opportunity to jumpstart nascent NCD programs. A recent partnership between the U.S. President’s Emergency Plan for AIDS Relief and AstraZeneca, aimed at offering HIV/AIDS and hypertension services in an integrated manner, is a step in the right direction. Recent initiatives, such as the Defeat NCD partnership and Resolve, can help accelerate the integration of NCDs into primary healthcare.

89%

of survey respondents believe a strong primary health care system must be able to prevent NCDs, detect and diagnose NCDs, and treat patients afflicted with NCDs.

“FamilyDoc is a chain of affordable community-based clinics in the Philippines that brings a GP, a pharmacy, and a diagnostic imaging service combined in one hub that is embedded in a peri-urban or a rural, semi-rural community on the outskirts of major urban centers. When the private sector makes models like that work, it lessens the burden on tertiary institutions, it increases access for the underserved population because they don’t need to commute two hours to get an x-ray, and I think it also introduces a welcome element of innovation.”

— Carl Ng, Chief Resource Officer

LifeTrack Medical Systems

Survey respondents indicate a variety of ways strong primary healthcare can contribute to the fight against NCDs: 46 percent of survey respondents believe that prevention and behavior change is the most important component of an overall effective primary health care approach, while the top answer for 45 percent is early detection and diagnosis capability.

Ways strong primary health care approaches contribute to the fight against NCDs

Increases access to drugs, facilities, technologies and trained personnel

Holistic and multisectoral approach that strenghtens health systems from first point of contact to referral to specialized centers

Awareness creation, promotion, and education

Early intervention and treatment

Early detection and diagnosis

Prevention and behavior change communication

Health professionals acknowledge many interrelated factors in order to facilitate early detection and diagnosis. For instance, strong primary care is one important element in the pursuit of universal health coverage. LMICs require strong government policy to unlock funding for primary care and universal health coverage. Meanwhile, trained health workers and medical innovation are necessary components of improving primary care. Our survey respondents indicate that these factors and others are instrumental in tackling effective diagnosis of NCDs.