Access to high-quality health services critically depends on the size, skill-mix, competency, geographic distribution and productivity of the health workforce. Health workers are the cornerstone of health care systems.

Consultations with doctors are an important measure of overall access to health services, since most diseases can be managed effectively in primary care without hospitalisation, and a doctor consultation often precedes a hospital admission.

The need to prevent diseases, diagnose early and treat effectively under the Universal Health Coverage mandate of the Sustainable Development Goals 3 calls for safe, effective, and appropriate medical care.

Hospitals in most countries and territories account for the largest part of health care expenditure. Capacity of the hospital sector and access to hospital care are assessed in this report by the number of hospital beds and hospital discharge rates. However, increasing the numbers of beds and overnight stays in hospitals does not always bring positive outcomes as resources need to be used efficiently. Hence, the average length of stay (ALOS) is also used to assess appropriate access to and use of hospital care, but caution is needed in its interpretation. Although, all other things being equal, a shorter stay will reduce the cost per discharge and provide care more efficiently by possibly shifting care from inpatient to less expensive post-acute settings, too short a length of stay may reduce the comfort and hamper the recovery of the patient or increase hospital readmissions.

Antenatal care, delivery attended by skilled health professionals and access to health facilities for delivery are important for the health of both mothers and their babies as they reduce the risk of birth complications and infections (see indicators on “Infant feeding” in Chapter 4). WHO currently recommends a minimum of eight antenatal contacts (WHO, 2016[1]), and antenatal care coverage has been monitored to ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes by 2030 (Sustainable Development Goal 3.7). Receiving antenatal care at least four times increases the likelihood of receiving effective maternal health interventions during the antenatal period. This is one of the indicators in the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) Monitoring Framework, and one of the tracer indicators of health services for the universal health coverage (SDG indicator 3.8.1)

Basic care for infants and children includes promoting and supporting early and exclusive breastfeeding (see indicators on “Infant feeding” in Chapter 4) and identifying conditions requiring additional care and counselling on when to take an infant and young child to a health facility. There are several cost-effective preventive and curative services for leading causes of childhood morbidity and mortality. These comprise vitamin A supplementation, measles vaccination, oral rehydration therapy (ORT) and zinc supplementation for severe diarrhoea, and antibiotic treatment for acute respiratory infection (ARI) (Bhutta et al., 2013[1]).

For the first time, world leaders have recognised the promotion of mental health and well-being, and the prevention and treatment of substance abuse, as health priorities within the global development agenda. The inclusion of mental health and substance abuse in the Sustainable Development Agenda, which was adopted at the United Nations General Assembly in September 2015, is likely to have a positive impact on communities and countries and territories where millions of people will receive much needed help. A particular prevention priority in the area of mental health concerns suicide, which accounted for an estimated 793 000 deaths in 2016 (WHO, 2018[1]). Target 3.2 of the Mental Health Action Plan 2013‑20, calls for a 10% reduction in the rate of suicide in countries by 2020. The UN Sustainable Development Goals include target 3.4 to address non-communicable diseases and mental health with an indicator to reduce suicide mortality by a third by 2030.

People should be able to access health services when they need to, irrespective of their gender, economic status, education, and place of residence. The United Nations 2030 Agenda for Sustainable Development aims to leave no one behind, and it is said explicitly in SDG 10 “to reduce inequality within and among countries”. SDG 3 is a call to ensure healthy lives and promote well-being for all at all ages, which implies tackling inequalities in health. However, differences in access to health care for women aged 15‑49 either due to financial issues or distance to health facility are commonplace across countries in Asia-Pacific. Additionally, an extra layer of restrictions on access to health care for indigenous women in Asia-Pacific seems to exist as well, with indigenous women experiencing more health vulnerabilities when compared to non-Indigenous women, including continuous challenges and barriers to access quality and equitable health care services (Thummapol, Park and Barton, 2018[1]).