Universal Health Coverage and Primary Healthcare: Lessons From Japan; Comment on “Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries”

Document Type: Commentary

Author

Institute of Development Studies, University of Sussex, Brighton, UK

Abstract

A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant.

Keywords

Main Subjects


  1. Ikegami N. Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries. Int J Health Policy Manag. 2016;5(5):291-293. doi:10.15171/ijhpm.2016.22
  2. Bloom, G. Standing, H. and Lloyd, R. Markets, information asymmetry and health care: towards new social contracts. Soc Sci Med. 2008;66(10):2076-2087. doi:10.1016/j.socscimed.2008.01.034
  3. Sudhinareset M, Ingram M, Lofthouse HK, Montague D. What is the role of informal healthcare providers in developing countries? A systematic review. Plos One. 2013;8:e54978. doi:10.1371/journal.pone.0054978
    1. Bhuiya A, ed. Health for the rural masses: Insights from Chakaria. Dhaka, Bangladesh: ICDDR; 2009.
  4. Ahmed SM, Evans TG, Standing H, Mahmud S. Harnessing pluralism for better health in Bangladesh. Lancet. 2013;382(9906):1746-1755. doi:10.1016/s0140-6736(13)62147-9
  5. Gautham M, Shyamprasad KM, Singh R, Zachariah A, Singh R, Bloom G. Informal rural health care providers in North and South India. Health Policy Plann. 2014;29:i20-i29.
  6. Das J, Holla A, Das V, Mohanan M, Tabak D, Chan B. In urban and rural India, a standardized patient study showed low levels of provider training and huge quality gaps. Health Aff (Millwood). 2012;31(12):2774-2784. doi:10.1377/hlthaff.2011.1356
  7. National Institute of Population Research and Training (NIPORT). Bangladesh Maternal Mortality and Health Care Survey 2010. Dhaka, Bangladesh: NIPORT, Measure Evaluation and ICDDR; 2012.
  8. Zhang D, Unschuld PU. China's barefoot doctor: past, present, and future. Lancet. 2008;372(9653):1865-1867. doi:10.1016/s0140-6736(08)61355-0
  9. Liu Q, Wang B, Kong Y, Cheng KK. China's primary health-care reform. Lancet. 2011;377(9783):2064-2066. doi:10.1016/s0140-6736(11)60167-0
  10. Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a multicountry analysis. Lancet. 2003;362(9378):111-117. doi:10.1016/s0140-6736(03)13861-5
  11. Cornwall A, Shankland A. Engaging citizens: lessons from building Brazil's national health system. Soc Sci Med. 2008;66(10):2173-2184. doi:10.1016/j.socscimed.2008.01.038