Lao PDR Learning Districts: A People-Centered Approach to Service Delivery
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Washington, DC: World Bank
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In Lao People’s Democratic Republic (PDR), primary health care (PHC) is the main pathway toward universal health coverage (UHC). Despite progress in maternal and child health, major gaps persist for non-Lao Tai ethnic groups in remote areas, including challenges in accessing maternal care, nutrition services, and safe WASH practices. With support from the World Bank, the Government of Lao PDR has launched the Health and Nutrition Service Access II (HANSA II) Project to strengthen the quality and equity of PHC, particularly for underserved communities. Central to the project, the government has prioritized integrating essential health services - antenatal and postnatal care, immunization, nutrition support, WASH, and family planning - for improved ease of delivery and access to better address the health needs of these remote, disadvantaged communities. This report summarizes qualitative research conducted in two districts of Lao PDR to better understand the needs, beliefs, and barriers experienced by select non-Lao Tai groups (and the community actors who influence them) to improve access to and utilization of quality essential health services. Addressing this challenge called for approaches that can unpack its inherent complexity and point toward practical, implementable solutions fit for purpose and context. The applied Human-centered design (HCD) and systems thinking lens surfaced deeply dependent, multisectoral challenges across nutrition and the environment, social protection, cultural norms and more. It identified key areas requiring concerted intervention, including cultural barriers to the adoption of desired health and nutrition behaviors among the most traditional families (those with distinct challenges and needs within the broader non–Lao-Tai populations), structural issues with outreach programs, and health center readiness to respond to the demand motivated by the outreach programs.
Palabras clave
GOOD HEALTH, UNIVERSAL HEALTH COVERAGE (UHC), HEALTH SERVICE DELIVERY, HEALTH AND NUTRITION SERVICE ACCESS II (HANSA II) PROJECT