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

Abstract

Strengthening primary health care (PHC) is essential for achieving universal health coverage, with effective financing playing a critical role in its success. Despite the increasing emphasis on PHC investment, securing sustainable public financing remains a significant challenge in the countries of the South-East Asia (SEA) Region. This study provides an overview of PHC financing arrangements in Bangladesh, Indonesia, Maldives, and Nepal, highlighting key challenges in these four countries. Data sources included the document review (87 documents included across the four countries) and key informant interviews (21 in total). Findings highlight the diverse approaches to PHC financing across the four countries, bringing out common and country-specific challenges. Our findings suggest that while PHC has been receiving more attention in policy agendas, underlying PHC financing functions still face many challenges. Some constraints stem from the existing health financing models within these countries, indicating a need for targeted reforms. Funding: WHO South-East Asia Regional Office.