“How can needs be met when, for 16 years, staff in [health] facilities have not gone for any refresher training, when essential drugs cannot be dispensed in the facility and patients are left at the mercy of chemists– most of which sell fake drugs? Or when pregnant women have to wait long hours to see one doctor who comes occasionally and when these pregnant women have to be assisted by untrained health workers or traditional birth attendants during delivery?” Health worker in Rafin Zuru, Nigeria

With only a year to go until 2010, the rate of progress towards universal access to HIV and AIDS prevention, treatment, care and support needs to be stepped up.  ActionAid’s new report Primary concern concludes that primary health care is key to tackling HIV and AIDS and reaching the universal access targets.

Building on existing research, ActionAid conducted national and community level research in six countries – India, Pakistan, Nigeria, Sierra Leone, Tanzania and Uganda.  The research concluded that essential services for HIV and AIDS should be provided at the primary healthcare level.  HIV and AIDS services should be integrated with other related services provided at the primary healthcare level, including sexual and reproductive health and gender based violence response services.  

The research showed that quality really matters.  Primary healthcare is many poor peoples' only option for healthcare within the formal health system, especially women and girls.  However, patients will not use facilities if they know that they are understaffed, under-stocked or difficult or expensive to access. Improvements to primary healthcare facilities will increase community demand.

The report recommends improvements in funding, policy design and implementation, service design and delivery.