title: Universal coverage for primary health care is a wise investment: evidence from 102 low- and middle-income countries.
abstract: We aimed to provide systemic, empirical evidence on the coverage expansion of primary health care (PHC) linking to good health in low- and middle-income countries. We conducted a pooled, cross-sectional analysis using the 2011 World Health Statistics for World Health Organization Member States at low- and middle-income levels (n = 102). With life expectancy, infant mortality, and under-5 mortality as health indicators, we examined the effect of service coverage rate using variables under 2 domains: health expenditure and PHC (public health provision, primary care access). Our results indicated that after controlling for gross national income per capita, higher total health expenditure as share of gross domestic product was associated with shorter life expectancy (β = -0.99; P = .014), higher infant mortality (β = 1.65; P = .155), and under-5 mortality (β = 4.82; P = .020). Multivariate analysis showed higher coverage of public health services was significantly associated with improved population health. Making public health and primary care services accessible and be used by everyone is the wise means toward improved health.
authors.affiliation: China Medical University, Taichung, Taiwan.
authors.forename: Vivian Chia-Rong
authors.initials: VC
authors.lastname: Hsieh
authors.affiliation: National Taipei University of Education, Taipei, Taiwan.
authors.forename: Jennifer Chun-li
authors.initials: JC
authors.lastname: Wu
authors.affiliation: China Medical University, Taichung, Taiwan.
authors.forename: Trong-Neng
authors.initials: TN
authors.lastname: Wu
authors.affiliation: National Taiwan University, Taipei, Taiwan tlchiang@ntu.edu.tw.
authors.forename: Tung-liang
authors.initials: TL
authors.lastname: Chiang
mesh_terms: D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data*; D014943:Global Health; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008017:Life Expectancy; D019472:Universal Health Insurance / Q000706:statistics & numerical data*
keywords: infant mortality; life expectancy; primary health care; under-5 mortality; universal coverage