Improving access: Closing the upstream gap – Perspectives from Singapore, India, Kenya and Saudi Arabia (YEL 2026)

Authors: Abdulelah Alshammari (Ministry of Health, Saudi Arabia), Dr Benjamin Lee (NGH Health, Singapore), Deyaa Mukhtar (King Abdulaziz Hospital, Saudi Arabia), Irene Khalibwa Okang’a (Avenue Healthcare, Kenya), Anjana Sudheesan Puzhekadavil (Apollo Adlux Hospital, India).

Reviewers: Dr Abel George (Apollo Adlux Hospital, India) and Silvia Moreira Da Silva (Hospital de Cascais Dr Jose de Almeida, Portugal).

Alumni mentor for the group: Searchmore Chaparadza (Baines Intercare Medical Centre, Zimbabwe).

Health systems have traditionally been designed to respond to illness once patients enter formal care, yet many determinants of health operate much earlier.

Drawing on perspectives from India, Kenya, Saudi Arabia and Singapore, this article explores the “upstream gap” between where health needs emerge and where care is usually delivered. Through four case studies focusing on cervical cancer prevention, diabetes care, timely access to specialist expertise, and chronic disease prevention in an ageing population, the authors examine different faces of this gap and the approaches being used to address them.

Comparing these experiences, they identify five common themes: primary care as the foundation of upstream health; community care that brings health closer to where people live; digital health that addresses specific access barriers; integration to ensure that early access leads to completed care; and the conditions needed for successful initiatives to scale and remain sustainable.

The article concludes that closing the upstream gap requires healthcare leaders to look beyond the boundaries of hospitals and individual organizations, build stronger relationships with primary care and community partners, deploy digital solutions against specific access barriers, and take responsibility for continuity across the whole patient pathway. Ultimately, access means not only reaching healthcare, but being able to engage early, receive the right care and complete the journey.

Find the full article here!

Improving access: Closing the upstream gap – Perspectives from Singapore, India, Kenya and Saudi Arabia (YEL 2026)

Date: 23 September 2026

Written by:

Katherine Bennett

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