Opinion: Local service delivery based on a primary health care approach is the backbone of strong health systems

Did you know that local governments are responsible for delivering around 65% of the Sustainable Development Goal (SDG) targets? 

There’s no question about it: we cannot achieve universal health coverage (UHC, SDG target 3.8), or indeed any of the SDG health targets, without the local governments that are in direct contact with populations. 

Local governments play a crucial role in planning and delivering the services necessary to achieve UHC. They have the ability to build primary health care systems that are truly “caring” and people-centred, as they are directly responsible for protecting the health and well-being of their constituents. They are also closest to the communities and individuals they serve, often acting as the first point of contact.

But local governments alone cannot achieve health for all. We must support meaningful social participation and empower communities through formal participatory governance mechanisms. 

Civil society and community participation help to hold governments accountable and improve the responsiveness of UHC policies. They ensure programmes are integrated with social protection policies, reach their full impact and remain relevant for end-users. This is particularly important for women and girls, as well as for communities who often find themselves on the margins of society, such as migrants, persons with disabilities, persons living in poverty and the elderly. Women also shoulder the main burden for protecting our health at the frontline and in communities and must be supported in this work.

These are a few of the reasons local governments must be part of global health conversations and need stronger legal, institutional and fiscal frameworks that provide them with the necessary decision-making power to people’s needs – particularly those related to health and social protection.

UHC2030 is honoured to collaborate with United Cities and Local Governments (UCLG). Our collaboration emphasizes the importance of achieving UHC to support resilient and thriving communities. We facilitate dialogue between local government representatives and UHC advocates on how to build a safer and healthier future for everyone by making our health systems more resilient and equitable. 

We welcome the UCLG Pact for the Future as an important step to make the right to health a reality for all.

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