Primary health care

Comprehensive primary health care is the means to address NCDs. To adequately respond to the needs of people with NCDs and enable proactive population management, primary care in many settings will need to change (Fig. 7). Primary care services should be tailored to a defined catchment population to enable continuity of care and responsiveness to the changing disease burden. The size of the catchment population for primary care can be determined by the disease burden, population density, the health workforce model, and available resources. Transforming the current model of care to make primary health care the main provider of care for NCDs will require more efficient use of existing resources and, in many cases, additional resources for health services, with an increase in infrastructure, medical products, trained/skilled health workers, health information systems, and managerial capacity directed to primary care. Appropriate policy changes are needed for medical/health-worker education and professional regulation to strengthen and expand primary care (43).

While devolving prescriptive powers to mid-level, non-physician care providers, two aspects need to be considered: dispensing rights vs prescriptive rights; and clear definition of training, certification, and the context in which such prescriptive powers can be implemented.

It is important to prioritize resource allocations for prevention of NCDs and for primary health care strengthening to bring in the desired impact. The South-East Asia regional strategy for primary health care: 2022–2030 provides Member States with guidance on facilitating primary health care-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of primary health care, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana (44).

^{Fig. 7. Elements to be augmented in primary care to prevent and control NCDs}