PHCPI Blog

At the height of the COVID-19 pandemic in 2020, the Primary Health Care Performance Initiative (PHCPI), a partnership dedicated to transforming the global state of PHC, and the Joint Learning Network for Universal Health Coverage (JLN) convened groups of country health leaders in virtual cross-co

As a country famous for its long-distance runners, Kenya is now rapidly accelerating its pace towards achieving Universal Health Coverage (UHC).

Universal health coverage (UHC) is a world where everyone everywhere has fair access to essential health products and services required to live a healthy life.

“Our catchment population is 4084 and our biggest challenge is human resources. Only 2 nurses are covering this huge catchment population. According to Universal Health Care standards we are supposed to have 8 nurses.

Many countries have good policies and legislation to support Primary Health Care (PHC) frameworks.

“A building is only as strong as it’s foundation. The foundation for universal health coverage (UHC) in Kenya is primary health care (PHC),” said Dr.

The Primary Health Care Performance Initiative (PHCPI) is delighted to welcome the Global Fund as our newest core partner!

The COVID-19 pandemic has sparked unprecedented scientific speed, collaboration and investment to develop the vaccines that will be essential to ending the current crisis.

Peru, with 1,250,000 confirmed cases and more than 44,000 deaths, experienced the second most deaths as a country in Latin America in proportion to its population.

What impact has COVID-19 had on primary health care (PHC) systems, and what are the opportunities to overcome barriers and make “PHC for UHC” a reality? This blog looks at experience in Kenya. This blog was orginially published by UHC2030.

A look back upon the strategies taken to tackle COVID 19 in Italy and the role of PHC in the response.

As the world faces the COVID-19 pandemic and health care systems are strained by its effects, countries continue to be responsible for ensuring access to routine, high quality health care services. We have seen how disease outbreaks can disrupt traditional health care delivery models, leaving the most vulnerable populations without access to essential health services. How can we adapt our health care delivery models to ensure access to care during COVID-19 and beyond?  

When asked about her experience with COVID-19, Vineeta Ray, a Community Health Officer (CHO) supporting pandemic response efforts at a Health and Wellness Center (HWC) in the Indian state of Madhya Pradesh, said, “This disease is so dangerous; many people are getting infected and nobody knows how

As a health advocate and primary care physician leader in my community of Baringo, witnessing COVID-19 unfold around the world has pushed me to reimagine how the health system is structured, how I care for my community here at home, and the integration between the two.  

With a national shortage of tests, only those who met stringent criteria - those most likely to be positive - could be tested. The rest - the vast majority of likely COVID cases - remained in limbo. "But what if I have it? My mom has COPD. Can I even go home?" "I drive a bus. Do you know how many people could get sick if I have it?" With limited knowledge of how the disease spread and minimal access to PPE, we had many of these conversations on our cell phones, to patients on the other side of a closed exam room door.

Read more about experiences managing COVID-19 from South Boston. 

As COVID-19 spread worldwide, the importance of early action to reduce transmission became more and more clear. In Malaysia, the Ministry of Health initiated its preparedness plan on January 7, a full two weeks before the first case was reported in the country, and well ahead of the WHO declaring a pandemic. The government imposed a strict Movement Control Order (MCO) to slow the spread, which, while effective, created significant challenges for both the health and economic sectors. 

Read more on the response by Malaysia's Ministry of Health in this week's Primary Series piece. 

Since the late 1920s, the Sri Lankan health system has been centered on the foundation of formal primary health care (PHC). Given the country’s prioritization of equitable access for a population where ~70% of patients live in rural areas, Sri Lanka has seen remarkable health gains over the last several decades, including rising life expectancy due to reduced mortality among mothers, infants, and children. Sri Lanka has worked hard to integrate public health and primary care with health stations across the country in an effort to try to ensure all patients have a health facility - even just a one-person station offering basic clinical care and public health interventions - within 20 kilometers, and coverage of basic medical facilities are typically situated closer (~1.4km – 4km).

Read more on how a long term investment in primary health care has paid off in Sri Lanka. 

In Malawi, we have only now just begun to see the dramatic increases in COVID-19 cases that many other countries have – yet COVID has already made an impact on health services. As of this writing, Malawi only recently climbed above 100 cases, with very few deaths – in part we hope this is because of the swift action and well-meaning, coordinated efforts between the public and private sectors, and preventive and curative teams working towards one common goal.

Read this week's Primary Sources piece by Dr. Prosper Lutala, Dr. Martha Makwero, Dr. Modai Mneunula, and Dr. Anna McDonald, from Department of Family Medicine, College of Medicine, University of Malawi. 

Villa de Merlo, where I practice Family Medicine, is a town similar to many in Argentina, with approximately 25,000 inhabitants located in the Concarán Valley in San Luis province. As is the case in most of the region, Villa de Merlo’s health system is predominantly hospital-centric. Over the last ten years, however, the Municipal Health Department of Villa de Merlo San Luis has evolved a more comprehensive approach to health care, calling on the coordinated strengths of our multidisciplinary team, in collaboration with stakeholders throughout the territory.

Read reflections from Dr. Raúl Urquiza, on how primary health care improved the pandemic response in San Luis, Argentina . 

As the COVID-19 pandemic continues to unfold in Bangladesh, more confirmed cases and deaths are being reported in recent weeks. Bangladesh is one of the most densely populated countries in the world, with 1,200 people per square kilometer (compare this with China’s 148 people per square kilometer). Combined with the reality that a large portion of the population depends on shared transport, handwashing in public spaces is limited, and many people do not have enough income to stock up on essential commodities for weeks at a time, social distancing measures will be nearly impossible to sustain. 

Read reflections from Sylvana Sinha, Founder and CEO, Praava Health on how Bangladesh is responding to the COVID-19 pandemic and three ways primary care facilities can help reduce the burden on hospitals during this time so they can focus on treating severe COVID-19 patients.

In the initial months of the pandemic, Myanmar reported few COVID-19 cases, likely as a result of comparatively low numbers of international travelers and very limited testing capacity. In recent weeks, however, the virus has spread primarily in the commercial capital of Yangon, and the country now faces challenges in disease containment unique to lower-middle-income countries. While moderate isolation and movement restrictions have been implemented, socioeconomic realities make social distancing nearly impossible for much of the population. The government has responded with an assertive case-contact and quarantine policy, meaning on a nightly basis apartment buildings, hotels, hospitals, and neighborhoods are placed under government-enforced total movement restrictions.

Read reflections from Myanmar by  Dr. Kyaw Thu, Program Director, Myanmar Academy of Family Physicians and Dr. Christoph Gelsdorf, Regional Director, Global Health Collaborative at Boston University Dept of Family Medicine. 

Since the adoption of the Political Declaration in September, the global health landscape has shifted dramatically. No matter where in the world we live, we are all impacted by the COVID-19 pandemic. Although we’re in the midst of a global health emergency, it’s actually more important than ever that we prioritize and accelerate the investments in health systems and frontline health workers to achieve UHC. Dr. Diana Nambatya Nsubuga, Deputy Director of Living Goods Uganda highlights the critical role of CHWs to both the COVID-19 response and achieving UHC in Uganda. 

We are witnessing in real-time the spread of the COVID-19 pandemic around the globe, posing the most serious, world-wide challenge since Alma Ata to the goal of health for all. Colleagues have reached out about the shortage of personal protective equipment (PPE) and the need for more knowledge in managing this crisis, while researchers have rushed to collect and disseminate knowledge and lessons learned. It has been both heart wrenching and reassuring to see and read and hear so many stories of the dedication and commitment of those on the front lines, caring for patients and fighting this pandemic.

As the explosive impact of COVID-19 ripples globally, there’s a clear plea from many regions and countries: stay home and help “flatten the curve” of infection. People from China to Italy have seen the consequences of the virus spreading too quickly with hospitals overwhelmed and doctors forced to make heartbreaking decisions about who lives and dies.

This piece was originally published in Health Policy Watch on March 24, 2020.

Read our key takeaways from the 2020  Prince Mahidol Award Conference (PMAC) in Bangkok, Thailand. 

This year’s Universal Health Coverage (UHC) Day comes just weeks before the start of a new decade. As global advocates come together to ask world leaders to keep the promise of health for all, we’re reflecting on country-led progress from the past ten years that holds important lessons for the path forward.

The Improvement Strategies are a novel interactive knowledge management tool that health ministries, development partners, facility managers, advocates, and others can use to learn about the best evidence for improving primary health care and find practical recommendations for adapting these strategies to their context. They are designed to support users along their measurement to improvement journey.  

UNGA 74 opened with a historic moment as world leaders championed the central role of primary health care (PHC) in achieving the most ambitious and comprehensive set of health commitments ever adopted. PHC was at the heart of the political declaration UN Member States adopted at the world’s first High-Level Meeting on Universal Health Coverage (HLM-UHC). This exciting declaration will be the roadmap for the actions the world will take to make health for all a reality by 2030.

Hannah Ratcliffe, Assistant Director of Research on the Primary Health Care team at Ariadne Labs has led PHCPI's efforts to design and work with countries to scale implementation of the Primary Health Care Progression Model. Learn more by reading the "Five Question with Hannah Ratcliffe" interview, as she discusses how the Ariadne team is working to strengthen primary health care globally. 

This piece was originally published by Ariadne Labs, on August 20, 2019.

Read our three key takeaways from the 72nd World Health Assembly. 

Is it always best to integrate vertical programs with primary health care (PHC)? When? Which ones — or which parts of ones? And what are the risks?

Executive Director Beth Tritter sits down with UHC2030 to discuss PHCPI's motivation for joining, and the value of the UHC2030 agenda. 

Join us for an interactive community consultation on measurement for improvement in quality primary health care. We want to hear your perspectives and ideas!

The 30 practitioners from 13 countries across Latin America, Africa and Asia who gathered in Hanoi, Vietnam this September convened in the pursuit of a shared goal: achieving universal health coverage for their country’s citizens through strengthening their primary health care systems.

Jishnu Das, Lead Economist at the Development Research Group at the World Bank, recently wrote a letter to Oxfam encouraging a reframing of the questions about quality of PHC services in the private sector. 

Ariadne Labs is developing a Primary Health Care Measurement and Implementation Research Consortium. This Consortium will bring together researchers and policy makers from multiple disciplines representing academic institutions, government agencies, international organizations, and non-governmental organizations to accelerate progress in primary health care (PHC) research in low and middle-income countries (LMIC). We are issuing a request for proposals (RFP) to develop a report on the gaps in measurement and improvement and approaches to address these knowledge gaps in one of four areas critical to effective PHC in these settings.

While global programs focused on specific diseases have improved the health of populations worldwide, until recently there has been a lack of focus on programs or initiatives to improve primary health care.

Revitalizing Health for All examines 13 cases of efforts to implement comprehensive primary health care reforms in communities around the globe, including in Australia, Brazil, Democratic Republic of Congo, South Africa, and Iran. The case studies originated from an international research-to-action initiative that brought researchers and research-users from national public health systems together to design, implement, and assess local projects.

As the 70th World Health Assembly (WHA) meeting comes to a close, it is important to recognize that dialogue among country actors and the global community is critical for collective progress. In this open letter to WHA delegates, members of the Joint Learning Network for Universal Health Coverage Primary Health Care Measurement for Improvement Collaborative share key insights on the need to better measure and strengthen primary health care systems.

In November 2016, Qualis Health, a Seattle-based nonprofit population health organization, convened a symposium titled “Primary Care in the United States: Lessons Learned to Inform Global Efforts to Improve Primary Care” at the Bill & Melinda Gates Foundation headquarters. Sixteen experts from across the U.S. shared examples of healthcare delivery that illustrate high-functioning primary care, and described system innovations for improved care, better population health, and effective healthcare spending. Read—and watch—to see what lessons pockets of excellence in U.S. primary health care can inspire around the world.

In light of National Cancer Day on April 1, 2017, PHCPI reflects on the central role of primary care in cancer screening and treatment.

The latest guide from CHMI summarizes the learnings and active ingredients identified through the Primary Care Adaptation Partnership. Developed in collaboration with the participating programs, this guide builds off the knowledge they’ve accumulated over years of providing health care for the poor.

Public-private partnerships may help overcome barriers to access, strengthen capacity and build resiliance.

The JLN Primary Health Care Improvement Collaborative met in Kigali, Rwanda to outline strategies to address priority measurement areas and work towards the creation of a practical measurement toolkit.

As someone who has worked to strengthen health systems for more than 20 years, I’ve heard (and even made) a lot of arguments about whether one intervention versus another is more important or a better value for money.

The Ariadne Labs Primary Health Care team has been working with countries around the world on how to improve primary health care, a cornerstone of achieving universal health coverage.

Read on as Results for Development's Gina Lagomarsino explains why primary health care is the cheapest, fastests, most efficient way to achieve Universal Health Coverage.

The PHCPI partnership recently published an article in the Journal of General Internal Medicine underscoring why primary health care is essential to building strong health systems. The article gives insights into the core quality functions of primary health care, and provides a framework for understanding primary health care system performance.

This piece was originally published on Crossing the Divide, a Medium blog.

On this UHC Day, our colleagues at the Universal Health Coverage (UHC) Coalition call on global health leaders to commit to spending three-quarters of our time on domestic resource mobilization. If the world is serious about achieving UHC, we need to rebalance spending and put countries in the driver's seat.

On Monday, December 12, the world recognize Universal Health Coverage (UHC) Day. Share the videos and graphics below to spread the word about why primary health care is the fastest, cheapest, most efficient way to reach UHC.

Why is data so important to the success of health systems? The UCSF Global Health Sciences illustrates how data makes invisible people and problems visible, and is absolutely critial for health systems success. 

Over the last 15 years, Chile has developed a national shared monitoring plan for tracking the performance of its primary health care system. The plan consists of two parsimonious indicator sets: the Health Goals, which provide an economic incentive for frontline providers to meet service delivery targets, and the Activity Indicators, which increase financial transparency and ensure that municipalities are accountable for the health of their population. The process of data collection, review, and feedback is standardized throughout the country, and annual meetings allow for targets to be updated according to local needs. Chile’s monitoring system is an excellent example of how diverse stakeholders can work together to establish a simple method for assessing the overall performance of a primary health care system to promote accountability, incentivize quality, and drive improvement. 

Ghana created the Community-based Health Planning and Services (CHPS) initiative in 1994 to aim of reducing barriers to geographic access to primary health care. Read on to learn about the critical success factors of the program--community engagement and participation--and practical guidance for implementation.

Although it is estimated that mental health disorders account for 14% of the global burden of disease, there is a major treatment gap for people suffering from these issues in low and middle-income countries. A recent review available through the PHC Evidence portal provides evidence of the utility of non-specialist health workers and other professionals with health roles—including doctors, nurses, social workers, and teachers without specialized training—in closing the mental health treatment gap through better detection, treatment, and rehabilitation of mental illness. These findings have important implications for policymakers and researchers seeking to improve population health, increase effective coverage for mental health services, and improve the primary health care workforce.  

When you seek care, is the process is passive or participatory? How are decisions about your treatment made? Does your provider consider your preferences surrounding your care? Shared decision-making is a key mechanism for moving toward person-centered primary health care delivery. In a recent review available through the PHC Evidence portal, Hauser and colleagues assess the effect of shared decision-making on critical health outcomes, indicating that shared decision-making can strengthen provider-patient relationships, increase patient satisfaction, and improve clinical outcomes. Yet, more research is needed to develop scalable implementation pathways to support the integration of shared decision-making tools into routine care delivery and to generate standardized metrics to better assess this important function. Read on to learn more.

As countries around the globe grapple with aging populations, a rising burden on non-communicable diseases, and the omnipresent risk of outbreaks, developing people-centered, integrated health systems with primary care at their core becomes ever more essential. An analysis of 22 successful reforms reveal eight characteristics of successful primary health care reforms that countries can adopt to address their specific strengths, needs, and challenges. These tenets comprise a valuable framework for understanding the characteristics of high-performing middle and high-income country primary health care systems.

Why is primary health care so critical to achieving Universal Health Coverage (UHC)? A new infographic from the Primary Health Care Strategy Group illustrates why primary healthcare is the practical pathway to achieving UHC.

Since 2009 the Community of Practice Health Service Delivery under Harmonization for Health in Africa (HHA) has grown to more than 1,400 members from 78 countries. Over the past seven years, the community focused on building a network of district health management teams that values and prioritizes information sharing and learning through a horizontal learning environment. A recent test of fast learning cycles in Guinea and Benin revealed the role of the community in enabling peer-to-peer communication and information exhange among disparate groups. Read on for deeper insights from the Community of Practice Health Service Delivery into lessons learned on starting a scaling a successful global network. 

It is widely documented that antenatal care (ANC) provides women with information on health behaviors for pregnancy and childbirth, risks and warning signs, contacts and procedures in case of problems, and help planning for a safe delivery. However, ANC services are largely unavailable or underutilized in many low- and middle-income countries (LMICs). This comparative analysis highlights opportunities for countries to learn from the successes of their peers to promote more continuous care and increase equity in access to essential services. 

Despite progress made in the last two decades, maternal and child mortality rates remain unacceptably high around the globe. Read on to learn more about the role of strong primary health care systems in ending preventable maternal and child deaths and how more and better data can help the global community to ensure healthier lives for all women and children, everywhere.

Primary health care is one of the most cost-effective ways to equitably reduce morbidity and mortality and improve population health, but the realization of these potential benefits is dependent on having adequate numbers of competent, motivated human resources to deliver primary health care services. Read on for more information on the central role of health workers in achieving the health-related Sustainable Development Goals and opportunities to strengthen the health workforce.

Ariana Childs Graham, Director of the Primary Healthcare Initiative at PAI, shares her thoughts on primary health care (PHC) as the foundation of all health systems and the role of the Primary Health Care Global Strategy Group (PHCGSG) in increasing recognition and support for PHC in the global development arena and advocating for PHC as a foundational pillar of universal health coverage.

PHCPI was honored to participate in the momentous conversations at Women Deliver last week. Read on to see how PHC was featured during Women Deliver 2016.

How can strong supply chains strengthen primary health care systems? Read on for an exclusive PHCPI exploration of why essential drug availability is an essential component of effective primary care systems. 

Strengthening primary health care (PHC) is essential to achieve universal health coverage and the health-related Sustainable Development Goals, and PHC system strengthening requires good measurement. The PHC Measurement for Improvement Collaborative, launched in April 2016 in Accra, Ghana by the Joint Learning Network for Universal Health Coverage and the Primary Health Care Performance Initiative, will co-develop practical tools and approaches – drawing on collective country experiences—to support country policymakers, health system managers, and frontline providers to effectively use data for PHC improvement.

Please join us at Women Deliver 2016 for an event focused on meeting the needs of women and girls through primary health care, led by Suzanne Ehlers and featuring Honorable Awa Coll Seck, Dr. Atul Gawande, and Angel Chibuye Chewla . Read on for more details about location and speakers. 

Why is it important for countries to track and understand primary health care spending? Read on as Federica Secci, Health Specialist at the World Bank Group, discusses how accurate primary health care spending data is critical to improving systems and meeting Universal Health Coverage goals. 

Universal Health Coverage has been a priority in Nigeria since 2000, but it was really the National Health Policy of 2006 and the National Strategy Development Plan of 2010-2015 that elevated the need for UHC in Nigeria. Still, despite both these documents, not much progress towards UHC had been made until former President, Goodluck Jonathan, passed a declaration that called health a fundamental right and the responsibility of the government.

The Health Data Collaborative, launched by WHO and partner development agencies, countries, donors and academics, will strengthen countries' capacity to collect, analyse and use reliable health data, thereby reducing administrative burden. A list of 100 core health indicators has been produced, and 60 low income and lower-middle income countries, and their supporting donors, will be using common investment plans to strengthen their health information systems by 2024.

Read on to learn how the president of the World Organization of Family Doctors, Michael Kidd, thinks primary health care is key to meeting global goals for Universal Health Coverage and the Sustainable Development Goals. 

Countries around the globe have committed to implementing reforms to achieve universal health coverage. Now what? Read on for a snapshot of what the Primary Health Care Performance Initiative (PHCPI) has planned in 2016 to support the global movement toward UHC through better primary health care.

Commemerating the recent second annual UHC day, read on to understand how the UHC movement evolved from a nascent movement to a global force over the course of a few short years and learn why high-quality PHC is one of the best bets for achieving UHC goals.

At the Conference on Universal Health Coverage in the New Development Era, which took place in Tokyo, Japan on December 16, 2015, World Bank Group President Jim Yong Kim shared his insight on the global momentum around universal health coverage and highlighted new partnerships, including the Primary Health Care Performance Initiative, that can work to accelerate progress towards the achievement of universal health coverage goals. Read on for President Kim's full speech.

When you go to a health facility, are you able to see the same doctor or nurse as the last time you visited? If you see a specialist, do they use information from your primary care doctor to inform your diagnosis and treatment? Are you referred to a higher-level facility, if necessary, for follow-up care? For some of us, the answer is yes. But for too many of us, the answer is no. Read on to find out why continuity of care is a critically important, but poorly understood, role of PHC systems.

What is a young mother looking for when seeking health care for her child, her elderly father or herself? Quality primary health care. Quality can drive the necessary convergence of the current global dialogue on universal health coverage (UHC) and primary health care (PHC), as a sharp entry point to catalyzing change at the frontline of service delivery. In this blog, Dr. Shams Syed of the World Health Organization reflects on the need for action to support countries in utilizing PHC performance as a key driver in achieving universal health coverage.

When supported by strong public health policies and with aligned efforts across social, economic, and political domains, primary health care has a central role in achievement of sustainable development. Originally published in The Lancet, this commentary explores the integral role that strong primary health care systems will play in the achievement of the Sustainable Development Goals and Universal Health Coverage.

Imagine traveling an hour to reach a health facility, only to realize that no doctors are there. Or taking medication for a month, to later find out that you received the wrong diagnosis. Imagine being a doctor at a clinic so busy you see over 40 patients a day, and aren't able to give each one the full attention they need. Good health workers are the cornerstone to strong health systems. PHCPI investigates how we can better understand what makes health care providers most effective for the patients they serve. 

For the hundreds of thousands of women and newborns who die during pregnancy or delivery each year across Africa, the underlying cause of death is a fundamental lack of access to basic health care. In this op-ed originally published in AllAfrica, Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, highlights how primary health care and better data can help improve access to quality health care for women and their newborns.

Last month, world leaders came together to adopt the Sustainable Development Goals (SDGs)--a new global development agenda that sets ambitious targets, such as eliminate poverty, achieve gender equality and end hunger globally. Following the launch of the SDGs, World Organization of Family Doctors (WONCA) President Michael Kidd weighs in on the potential of primary health care systems to support the achievement of the health-related SDG and deliver quality health care to populations worldwide. He also proposes new indicators that, if comprehensively measured, can show us the strength of primary health care in countries around the world and help us understand how to further improve our systems.

What makes primary health care work? How can systems better function as a whole? Atul Gawande and Chris Elias speak with Devex about the challenges primary health care leaders face around the world, and how PHCPI is digging deep to understand these difficult questions.

To address the challenge of weak primary health care systems in low- and middle-income countries, members of the Joint Learning Network for Universal Health Coverage (JLN) Primary Health Care technical initiative have co-developed a diagnostic UHC Primary Health Care Self-Assessment Tool, a multi-stakeholder survey to help countries assess whether their health financing approaches are well aligned with primary care initiatives, efforts, and programs. Read on to learn more about the tool and discover highlights from early pilots in Malaysia, Ghana, Indonesia, and India.

With the launch of the new Sustainable Development Goals, health and development experts around the world are reflecting on what it will take to accomplish them. As a global community, this is a unique opportunity to think carefully about what works and what doesn’t, and to use the new goals to redouble our efforts to support programmes, solutions, and systems that work. Suzanne Ehlers, President and CEO of Population Action International, and Rosemary Mburu, Executive Director of World AIDS Campaign International, weigh in on the value of high-performing primary health care systems and call on country decision-makers to enact policies and budgets that lead to measureable improvements in primary health care.

On September 26, 2015 on the sidelines of the United Nations General Assembly, the Bill & Melinda Gates Foundation, the World Bank Group, and the World Health Organization launched a collaboration to strengthen primary health care and advance progress toward the Sustainable Development Goals.

Since the 1990s, Ghana has taken siginificant steps to improve primary health care, including launching the Community-Based Health Planning and Services (CHPS) program and ensuring financial access through the National Health Insurance Scheme. President John Dramani Mahama of Ghana joins fellow heads of state in signing the global framework for sustainable development and urges increased attention to strengthening health systems and enhancing the ability to respond to global health threats.

The global health agenda has often suffered from fragmentation, taking a siloed approach to particular diseases and interventions. During the Ebola crisis, we saw that underfunded, fragmented and understaffed health systems can be quickly overwhelmed, allowing an outbreak to escalate into an epidemic. Jasmine Whitbread, CEO of Save the Children International, shares insight into building strong health systems so that all can have access to high-quality health care.

Recent crises, including the Ebola epidemic in West Africa, have been wake-up calls: too many primary health care systems are under-resourced and fragmented, leaving countries unprepared to reach everyone with needed health services. Read more for a call to action from leadership of The Bill & Melinda Gates Foundation, the World Bank Group, and the World Health Organization on the need for better measurement to guide meaningful improvements in primary health care systems.

As one of the leading groups embracing the Alma Ata Declaration for Primary Health Care 40 years ago, nurses have been calling for strong primary health care for decades. Dr. Judith Shamian, President of the International Council of Nurses (ICN), shares her perspective on the impact of the Ebola outbreak and calls for action on the need to re-conceptualize primary health care systems with focus on the centrality of the healthcare workforce.

There is a growing commitment by Nigerian policymakers to address gaps in the health care system, including a strong focus on primary health care – the frontline of health. However, poor health outcomes persist throughout the country. No one appreciates more than we do that building a high-performing health care system, accessible to all, in our country is a great challenge, yet we are optimistic that Nigeria is on the right path. Muhammed Lecky, the Executive Secretary of the Health Reform Foundation of Nigeria (HERFON) and Tunde Segun, Nigeria Country Director for Evidence for Action (E4A), reflect on Nigeria's progress and the need for the right data and tools for evidence-based decision-making.

Health systems founded on strong primary health care are essential to achieve the Sustainable Development Goals and universal health coverage. Authors on behalf of the World Organization of Family Doctors' (WONCA) executive committee discuss the need for global primary care development indicators to strengthen primary health care systems. They call on the UN and other stakeholders to commit to the measurement and development of high-quality and comprehensive primary care. 

India's success in saving children's lives so far means that it hasn't just met but surpassed the UN's ambitious Millennium Development Goal (MDG) on child mortality. As the global community approaches the adoption of the new Sustainable Development Goals (SDGs) in September 2015, Bill Gates, founder and co-chair of The Bill & Melinda Gates Foundation, reflects on India's achievements and the need to make sure that primary health care systems reach every single person with high-quality services.