A/67/302
50. In addition to achieving more equitable health outcomes, allocating health
funds and resources with a focus on primary health care also promotes efficiency
within health systems. 53 Primary health care has been demonstrated to be more costefficient over the long term because it prevents illness and promotes general health,
reducing the need for advanced levels of curative care, which tend to be more
costly. 54 Savings resulting from investment in primary health care may be
reinvested in the health system and utilized to increase access to health care for the
poor, which in a virtuous cycle should further improve health outcomes. While a
comprehensive and balanced health system must include available and accessible
secondary and tertiary care services, States should prioritize primary health care in
the allocation of health funds and resources.
Rural, remote and urban areas
51. In order to achieve equitable health outcomes and full realization of the right
to health, States must allocate health funds and resources towards ensuring that
good quality health facilities, goods and services are available and easily accessible
for rural and remote populations. Populations in rural and remote areas have poorer
health than their urban counterparts globally. 55 Many otherwise preventable and
treatable illnesses are prevalent in rural and remote areas, infant and maternal
mortality rates are higher than in urban areas, and children experience higher levels
of malnutrition. 56 Moreover, people in rural and remote areas often have to travel
significant and difficult distances and spend large sums of money in order to access
health care, which is often not available in their communities owing to a lack of
investment in physical health infrastructure in rural and remote areas. 57
52. For example, the right to health requires that States take steps towards
improving maternal health and reducing maternal mortality. However, owing to
inadequate allocation of health funds and resources to rural and remote areas,
maternal health-care services, trained maternal health-care workers and good quality
health facilities are often unavailable in those areas. 58 Women are thus unable to
access maternal health-care services in their communities, and instead must travel
considerable distances at significant costs to obtain care. As a result, women in rural
and remote areas experience lower rates of live births attended by skilled health
workers58 and significantly higher levels of maternal mortality and maternal
morbidity than women in urban areas. 59
53. The right to health also requires that States ensure that good quality health
facilities, goods and services are available and accessible on a non-discriminatory
basis. In many States, rural and remote populations largely comprise vulnerable or
marginalized groups, such as the poor, ethnic and racial minorities, and indigenous
__________________
53
54
55
56
57
58
59
12-46101
WHO, “Primary health care as a strategy for achieving equitable care”, p. 32.
WHO, World Health Report (2008), Primary Health Care: Now More Than Ever (Geneva,
2008), pp. xvii, 42-51.
WHO, “Inequities in health care and health outcome (2008)”, pp. 92-95.
Pan American Health Organization, Health in the Americas, vol. 1 (Washington, D.C., 2007), pp. 58,
60, 62.
Mandy Leveratt, “Rural and remote Australia — Equity of access to health care services”, The
Australian Health Consumer, No. Two (2006-2007), pp. 16-17.
WHO, Maternal Health: Investing in the Lifeline of Healthy Societies & Economies (September
2010), p. 10.
WHO, “Making Pregnancy Safer”, Maternal Mortality Factsheet (Geneva 2008).
19