Integrative Review on Primary Health Care Financing in National Health Systems: Ensuring Access and Equity

Abstract

It identifies what the national and international scientific literature has made available on the financing of primary health care (PHC) in national health systems, in terms of expanding access and ensuring equity. This is an integrative literature review, in which the research was carried out in the Virtual Health Library (VHL) and PubMed. Twenty-one publications were analyzed, referring to 16 different countries. The countries with the highest number of publications were: Australia (4), Brazil (4) and Cambodia (4), followed by Argentina (2), Colombia (2) and Laos (2), in addition to another 10 countries with one publication each. The results indicate that there is not a single possible financing model, as well as there is no consensus among the authors for the concepts of access and equity. There is consensus, however, in the belief that PHC should be the guiding strategy of the care model and should be financed appropriately according to the health needs of each population. The financing models were summarized as public, based on taxes, through mandatory social contributions, or through health insurance in the private system. Additionally, the existence of Health Equity Funds (HEFs) in Cambodia proves that it is possible to find alternatives to guarantee access and equity. Each country, in its own way, seeks to guarantee access and equity in the health of its population. However, despite the guidelines of the World Health Organization or the Universal Declaration of Human Rights, with no consensus between the meaning and measurement of these terms, each country seeks to solve it in the way that suits you best. Finally, the compiled evidence allows us to conclude that the topic is very incipient, with a low level of scientific evidence available (levels 4 and 5).