Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 5:38:100613.
doi: 10.1016/j.lansea.2025.100613. eCollection 2025 Jul.

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

Aungsumalee Pholpark  1 , Hsu Myat Mon  2 , Leonard Thomas Lim  3 , Tsolmongerel Tsilaajav  4 , Valeria de Oliveira Cruz  4 , Piya Hanvoravongchai  2
Affiliations
Review

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

Aungsumalee Pholpark et al. Lancet Reg Health Southeast Asia. .

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.

Keywords: Bangladesh; Indonesia; Maldives; Nepal; Primary health care financing; South-East Asia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Hanson K., Brikci N., Erlangga D., et al. The lancet global health commission on financing primary health care: putting people at the centre. Lancet Glob Health. 2022;10(5):e715–e772. - PMC - PubMed
    1. Evans T., Chowdhury A., Evans D., et al. Health Insurance System Research Office; Nonthaburi, Thailand: 2012. Thailand's universal coverage scheme: achievements and challenges. An independent assessment of the first 10 years (2001-2010)
    1. Stenberg K., Hanssen O., Bertram M., et al. Guide posts for investment in primary health care and projected resource needs in 67 low-income and middle-income countries: a modelling study. Lancet Glob Health. 2019;7(11):e1500–e1510. - PMC - PubMed
    1. Perry H.B., Sachs J.D. Oxford University Press; 2024. The investment case for strengthening primary healthcare and community health worker programs in low- and lower-middle-income countries.
    1. Pholpark A., Mon H., Lim L., Hanvoravongchai P. World Health Organization, South-East Asia Regional Office; Delhi: 2023. Financing of primary health care in South-East Asia Region: findings from systematic scoping review and key informant interviews.

LinkOut - more resources