A Primary Health Services Model for Low- and Middle-Income Countries

Most health care needs can be addressed through first contact primary health services which are associated with better access health outcomes and population health, and greater health equity. Community-oriented primary care is medical practice that takes responsibility for the health of a defined population. The key components of such practice are community health workers, virtual care providers, and ambulatory facility centers. The internet with immediately accessible health expert information such as diagnostic and treatment guidelines, and the availability of new point-of-care diagnostic capacities such as ultrasound imaging, have significantly changed the optimal scope of primary health services. This communication suggests what that scope can be in low- and middle-income countries. Primary health services can: • Be for individuals of all ages. • Be comprehensive in addressing prevention (through detailed attention to ecological stressors as causes of systemic inflammation), diagnosis and treatment of biological and psychosocial illness, and virtual home hospital care. • Have high non-professional: professional (physician) staff ratios. • Provide education, coordination, and management • Be navigational for specialty care • Help control patient health expenditures • Promote public health and social justice • Offer procedures for diagnostic imaging with ultrasound, pulmonary function assessment, gynecological examinations, and treatment of common traumatic injuries. • Embrace A.I. tools and clinical research. A parallel scope of physician tasks as human health biology psychology and education practitioners can be intellectually, emotionally and financially rewarding. Broader training in biological and health, but critically in social and humanistic domains, will be essential to achieving successful development of these models.