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Primary healthcare for all
Published in Al-Ahram Weekly on 25 - 04 - 2019

On the occasion of World Health Day 2019 on 7 April a joint UN Children's Fund and World Health Organisation (UNICEF-WHO) celebration took place by the River Nile, with young people participating in the occasion by practising sports on a sunny day at Cairo's Mohamed Ali Club.
“Today's event brings together people from different organisations, demonstrating the spirit of solidarity and action that we need in our region to achieve our vision of ‘Health for All by All',” Ahmed Al-Mandhari, WHO regional director for the Eastern Mediterranean region, said in a speech at the event.
“In the Eastern Mediterranean region, WHO and our member states are promoting family practice-based primary healthcare,” he added, echoing WHO Director-General Tedros Adhanom who said that “family practice is the best way to provide integrated health services at the primary healthcare level.”
Primary healthcare (PHC) is essential healthcare based on scientifically sound and socially acceptable methods making universal healthcare accessible to all individuals and families in a community.
World Health Day
For the WHO, PHC is defined by “empowering people and communities, multisectoral policy and action, and essential public health functions at the core of integrated health services.”
Al-Mandhari said that one of the major targets of the UN Sustainable Development Goals (SDGs) was achieving universal health coverage (UHC). Primary healthcare is a necessary foundation for this, he said, noting that “reaching all people, with priority to the most disadvantaged, is a key element of UHC”.
PHC is essential to address each of these aspects of UHC. “It is important to note that between 80 and 90 per cent of essential health services can be delivered at the PHC level — including countries in an emergency,” Al-Mandhari said.
He announced the launch of a regional initiative to strengthen primary healthcare. “Following the old adage that what gets measured gets done, we plan to initiate standardised and in-depth assessments of PHC systems in the countries of the region. These assessments will be undertaken in partnership with a very important global initiative — the Primary Health Care Monitoring and Improvement Initiative,” he said.
He thanked the US-based Bill and Melinda Gates Foundation for supporting the region in implementing the initiative over the next two years.
Ethan Wong, a programme officer at the foundation, explained that it invests in primary healthcare because this is the front line of health. “A strong PHC can manage more than 80 per cent of healthcare needs. It can save lives as countries with strong PHC see fewer children die before their fifth birthday and more people live longer, healthier lives,” he said.
Wong said that half the world's population still lacks access to a full package of basic health services, most of which can be delivered through primary healthcare. He said that the WHO had reported that for the world to meet the SDGs by 2030 it would require investments in PHC to roughly double.
World Health Day
To improve PHC around the world, “we need better data and leaders who are committed to using it to drive improvements,” Wong said.
“That's why the Gates Foundation, the WHO and the World Bank have come together to launch the Primary Health Care Performance Initiative, a partnership dedicated to improving the global state of PHC, beginning with better measurement,” he said.
According to Al-Mandhari, “World Health Day 2019 puts a special emphasis on equity and solidarity — on raising the bar for health for everyone, everywhere, by addressing gaps in services and leaving no one behind. These are core principles in our new Vision 2023 for public health in the region, which calls for solidarity and action to achieve ‘Health for All by All'.”
UNICEF Regional Director for the Middle East and North Africa Geert Cappelaere said in his speech at the event that “PHC remains a key lifeline for millions of families and children in humanitarian settings.”
UNICEF and the WHO must continue to find joint ways of making this investment part and parcel of government budgets, starting with immunisation, he said, adding that Article 24 of the UN Convention on the Rights of the Child could be advanced through UHC in several ways.
“By covering the whole population, governments, as duty-bearers, take steps to guarantee the right to health of children,” Cappelaere said. “If PHC services are not accessed by all children who need them when they need them, then it is not UHC,” he concluded.
Fresh fruit and healthy foods were served as a simple message to the participants of the need to eat healthily and to engage in physical exercise in order to lead a healthy lifestyle.
“With a healthy lifestyle, life becomes more enjoyable,” said Alia Hisham, 18. Hisham said that after going on a healthy diet she had become more sociable and more confident.
Fadi Youssef, 21, agreed with Hisham, adding that “I think all the time about my health.” He does not smoke, and he has engaged in karate and played football since he was five years old.
Older people also have the opportunity to live a healthy life. Faten Shamout, 53, told Al-Ahram Weekly that she had started practising sports 15 years ago. “It is a must to start my day with some aerobic exercises to activate the circulation and help the blood to enter the tissues and joints and make them more flexible,” she said.
For Shamout's mother, Khadija Abbas, 75, sports were a luxury when she was young as she was busy raising her children and health was not a priority. “Now my daughter plays YouTube stretching exercises for the bones and muscles that I can do while sitting,” she said.

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