Experts meet to reflect on the challenges in financing Primary Health Care in the countries of the Region


Washington DC, May 29, 2024 (PAHO) – To share experiences and identify challenges in the financing of primary health care, and to analyze the prioritization of PHC in public spending in countries of the Americas, a virtual seminar was held, bringing together 688 participants from 51 countries and territories. This event was part of a Webinar series on Primary Health Care (PHC) with a territorial perspective, which seeks to explore the challenges and opportunities that arise on the path to developing health systems based on PHC.

Ernesto Báscolo, head of the Primary Health Care and Integrated Service Provision Unit (HSS/PH), PAHO/WHO, emphasized that “a territorial view of the PHC approach in the region is important”, and the value of this series lies in “articulating knowledge and technical cooperation with the experiences of the countries of the region”.

The virtual seminar opened with the presentation of the publication Analysis of the Budgetary Performance of the Health Sector in the period 2019-2021 by Claudia Pescetto, advisor in Health Economics and Financing, PAHO/WHO. This study, which includes eight countries in the region, analyzes the degree of alignment between the need to prioritize the first level of care with health budget performance and the health sector's absorption capacity of the increase in financial resources during the critical years of the COVID-19 pandemic.

Focusing on Peru, Hernán Rodríguez, advisor on Health Systems and Services, from PAHO/WHO in that country, presented the results of a study on prioritization of investment in PHC. The study, to be published soon, analyzes the increase in financing for the first level of care in the MINSA-GORE subsystem and in ESSALUD between 2019 and 2022.

Connecting this discussion to the challenges of achieving resilience in health systems were Sebastian Bauhoff, Chief Health Economist at the Inter-American Development Bank, and Cristian Herrera, Senior Health Specialist in the Latin American Region and the Caribbean at the World Bank. These institutions, along with PAHO, have recently formed the Alliance for Primary Health Care in the Americas. The panelists offered a regional perspective on the efficiency of health spending and increasing investment to built resilient health systems prepared to face adverse contexts such as the COVID-19 pandemic. These comments are closely related to the guidance offered by the Strategy for Establishing Resilient Health Systems approved by PAHO/WHO Member States in 2022.

Finally, a round of comments was held to gather countries' perspectives on the PHC financing panorama and the pending challenges for its prioritization in health investment. Speakers included Ximena Barros, coordinator of the Universal PHC Financing table of the Ministry of Health of Chile; Osvaldo Britez and Susana Cabrera of the Planning and PHC departments of the Ministry of Health of Paraguay; and Brenda Morales, from the Planning and Evaluation Unit of the Ministry of Health of Honduras.

After hearing the countries' experiences, James Fitzgerald, director of the Department of Health Systems and Services, PAHO/WHO, concluded that “the comments from Paraguay, Honduras, and Chile indicate that there is no single solution to operationalize the increases in investment in PHC (…) and that the context and organization of financing and service delivery will be the central determinant of the process in each of the countries. But it is clear that we must continue generating evidence on good practices and on these challenges of allocation and effective use of financial resources.” 

To close, he emphasized the importance of the partnership and collaboration between the institutions that form the Alliance. “There is a lot of work to do from our institutions and that is why we are betting on this Alliance as a mechanism that allows us to advance the agenda of transformations and strengthening of resilient health systems based on PHC.”

Watch the full video of the webinar here 

More information about the Alliance for Primary Health Care here

Learn more about the Webinar series on PHC with a territorial perspective here