Synthesising key findings from Indonesia's first civil society-led forum on primary health care: PHC forum, Jakarta, 13-14 November 2023

Abstract

Background: Despite evidence showing the important role of a robust primary health care (PHC) in achieving health equity, many nations still need strong, directional policies and unyielding commitments to strengthening PHC after the Astana Declaration. The "PHC Forum: Towards Health Equity and Resilient Communities" was held in November 2023, in Jakarta, Indonesia, to discuss the challenges and opportunities in actualising the commitments towards a robust PHC system globally.

Methods: This paper presents a thematic analysis of the PHC Forum. The Forum was organised into two days with a total of 783 participants, categorised as policymakers, academics, health workers, civil society leaders, and community members, mostly from the Global South countries. The Forum aimed to democratise stakeholders participation by creating an inclusive platform for all relevant actors, including civil society organisations (CSOs) and community health workers (CHWs). This was intended to generate empirical insights derived from lived experiences. To synthesise key findings from the Forum, expert statements were systematically compiled, categorised, and triangulated with relevant prior studies.

Results: The Forum resulted in the identification of key messages that can be organised into seven themes: (i) health for all vision, reinforcing that investing in a robust PHC system is central to achieving the universal health coverage (UHC); (ii) community participation and empowerment, reiterating community not just as beneficiaries; (iii) importance of CHWs, with a focus on realising decent work; (iv) financing and prioritisation, calling for increased investment towards PHC; (v) innovations, underlining the role of innovative technologies and approaches to improve health equity; (vi) PHC integration, stressing the need for both vertical and horizontal integration of public and private health services; and (vii) climate change, with an emphasis on recognising the increasingly critical role of a robust PHC system in facing climate change.

Conclusions: The key messages that emerged from the Forum emphasise the essential elements for building a robust PHC system, particularly in the Global South. A paradigm shift beyond health to focus on the bigger systems is needed to achieve health for all. The Forum emphasised that communities are the leaders in PHC transformation, driving towards equitable health outcomes.

Keywords: Civil society; Community; Health equity; Primary health care.