PHCPI Blog

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.