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Challenging inadequate and fragmented primary health care financing: findings from Bangladesh, Indonesia, Maldives, and Nepal - P4H Network

Challenging inadequate and fragmented primary health care financing: findings from Bangladesh, Indonesia, Maldives, and Nepal

Strengthening primary health care (PHC) is central to achieving universal health coverage in the WHO South-East Asia Region. This study, published in The Lancet Regional Health – Southeast Asia and Health Policy, analyses PHC financing arrangements in Bangladesh, Indonesia, Maldives, and Nepal—four countries with mixed health systems and ongoing reform efforts. Despite increasing policy attention, securing sustainable and equitable public financing for PHC remains a persistent challenge.

Authored by Aungsumalee Pholpark (P4H Coordination Desk), Hsu Myat Mon, Leonard Thomas Lim, Tsolmongerel Tsilaajav, Valeria de Oliveira Cruz, and Piya Hanvoravongchai, the study identifies systemic issues such as fragmented funding flows, low budget allocations, and weak provider incentives. The findings point to the need for targeted reforms—improving financial autonomy at the primary care level, introducing performance-based payment mechanisms, and enhancing data systems to track PHC spending. These insights aim to inform policy strategies that strengthen PHC delivery and financial resilience across the region.

Reference
Aungsumalee Pholpark, Hsu Myat Mon, Leonard Thomas Lim, Tsolmongerel Tsilaajav, Valeria de Oliveira Cruz, Piya Hanvoravongchai, Challenging inadequate and fragmented primary health care financing: findings from Bangladesh, Indonesia, Maldives, and Nepal, The Lancet Regional Health South East Asia, 05 Jun 2025