Integrated care: putting principles into practice and becoming the paediatrician of the future

Acute hospital paediatric services and separate primary care paediatricians, with links often fragmented, there is evidence that this delivers neither seamless nor equitable care. Integrating care around population needs is the direction of travel. The recent UK restructure into integrated care systems intends to facilitate improved collaboration and equity of health and care across geographies. Within child health, the Royal College of Paediatrics and Child Health’s (RCPCH) 2040 project describing future models of care has the ‘development of integrated care for children and young people at scale across the UK’ as a key goal.

WONCA Europe Conference: Innovating Family Medicine Together for a Sustainable Future

WONCA Europe 2022 Conference takes place from 28 June to 1 July 2022 and will be held conjointly with RCGP (Royal College of General Practitioners) 2022 Annual Conference as one event.

Registration, programme and further information

Introducing The Lancet Global Health Commission on financing primary health care: putting people at the centre

Integrated Care in Aotearoa New Zealand 2008–2020

Ten years ago, progress towards integrated care in Aotearoa New Zealand was characterised as slow. Since then, there has been a patchwork of practices occurring under the broad umbrella of integrated care. These include: collective planning approaches (i.e., alliancing), agreed pathways of care, chronic care management initiatives, shared patient information systems, co-located centres and indigenous models of holistic care (e.g., Whanau Ora).

Strengthening primary health care: contributions of young professional-led communities of practice

Health systems that have strong primary health care at their core have overall better patient outcomes. Primary health care is key to achieving Universal Health Coverage and the broader health-related Sustainable Development Goals by 2030. In 2018, at the launch of the Declaration of Astana, the World Health Organization formed the inaugural Primary Health Care Young Leaders’ Network. This paper aims to demonstrate the scope for young professional-led communities of practice in fostering support systems for young leaders and strengthening the delivery of primary health care at multiple levels.

Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of 'Health for All'. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework.

Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs, with results varying by indicators of SES and study settings.

Community-oriented primary care for National Health Insurance in South Africa

This is a report on Chiawelo Community Practice (CCP) in Ward 11, Soweto, South Africa, a community-oriented primary care (COPC) model for National Health Insurance (NHI) in South Africa, developed by a family physician.

A shift to capitation contracting for primary health care (PHC) under NHI will carry risk for providers – both public and private, especially higher number of patient visits. Health promotion and disease prevention, especially using a COPC model, will be important. Leading the implementation of COPC is an important role for family physicians in Africa, but global implementation of COPC is challenged. Cuba and Brazil have implemented COPC with panels of 600 and 3500, respectively.

The family physician in this report has developed community practice as a model with four drivers using a complex adaptive system lens: population engagement with community health workers (CHWs), a clinic re-oriented to its community, stakeholder engagement and targeted health promotion. A ...

Care for caregivers- a mission for primary care

The number of elderly people living in the community who are limited in daily activities is increasing worldwide. This generates prolonged care, which usually falls on one family member, the family caregiver. Caregivers are prone to develop psychosocial and physical symptoms. As a result, the World Health Organization (WHO) issued a clear directive to assess and support these caregivers. The main goals of this study were to assess primary care physicians’ (PCP) awareness to caregivers’ health risks and the extent that they recommended preventive measures to maintain the health of the caregivers. Although a high percentage of physicians were aware and concerned about caregivers’ health, their preventive care activities were relatively passive. PCPs should take a more active and preventive role for maintaining caregivers’ health.

The impact of the Covid-19 pandemic on primary health care utilization: an experience from Iran

The Covid-19 pandemic affected the performance of Primary Health Care (PHC) worldwide. This study was performed to investigate the impact of the Covid-19 pandemic on the utilization of PHC in Iran. Covid-19 Pandemic has affected the performance of Iranian PHC at the beginning and overall, has a negative consequence on utilization of services. Preparedness to respond to pandemics and develop programs and interventions is necessary to cover the weaknesses of the PHC.

The Lancet Global Health Commission on financing primary health care: putting people at the centre

Primary health care: health systems, communities and the planet

How do nurses support chronically ill clients’ participation and self-management in primary care? A cross-country qualitative study

In the context of the advancement of person-centered care models, the promotion of the participation of patients with chronic illness and complex care needs in the management of their care (self-management) is increasingly seen as a responsibility of primary care nurses. It is emphasized that nurses should consider the psychosocial dimensions of chronic illness and the client’s lifeworld. Little is known about how nurses shape this task in practice. The aim of this analysis is to examine how primary care nurses understand and shape the participation of patients with chronic illness and complex care needs regarding the promotion of self-management. Guided interviews were conducted with nurses practicing in primary care and key informants in Germany, Spain, and Brazil with a subsequent cross-case evaluation. 

Tuberculosis treatment management in primary healthcare sectors: a mixed-methods study investigating delivery status and barriers from organisational and patient perspectives

Tuberculosis (TB) treatment management services (TTMSs) are crucial for improving patient treatment adherence. Under the TB integrated control model in China, healthcare workers (HCWs) in the primary healthcare (PHC) sectors are responsible for TTMS delivery. This mixed-method study aimed to explore the status of and barriers to TTMS delivery faced by HCWs in PHC sectors from the health organisational and patient perspectives.

Building primary health care teams for universal healthcoverage in Africa

The Alma Ata Declaration on Primary Health Care (PHC) in 1978 defined PHC profoundly. Comprehensiveness and continuity of care, as well as coordination of referrals, were key attributes of integrated PHC. Unfortunately, African governments function with bureaucratic health systems, where top-down implementation policies, especially selective PHC vertical programmes driven by international agencies, create rigid, large, impersonalised units of PHC. Global agencies and country leaders must be challenged on this: what are they doing practically to build PHC teams for UHC in Africa?

The role of primary care in informing and supporting people with limited health literacy in the Netherlands during the COVID-19 pandemic: a qualitative interview study

During the coronavirus disease 2019 (COVID-19) pandemic, people have been confronted with a large amount of information about the virus and the governmental measures against its spreading. However, more than a quarter of individuals have limited health literacy (HL), meaning that they have difficulty finding, understanding, and applying health information. The purpose of this interview study was to investigate how individuals with limited HL acquire information about COVID-19 and governmental measures, what difficulties they experience in understanding and applying it, and what may be needed to overcome these difficulties. We also addressed other problems that they might face as a result of the pandemic. Using our findings, we aimed to make recommendations on the possible role of primary care in informing and supporting patients with limited HL during the pandemic.

Universal Health Coverage Partnership

The UHC Partnership helps deliver WHO’s support and technical expertise in advancing universal health coverage through a primary health care approach in 115 countries, representing a population of at least 3 billion people.

The UHC Partnership is one of WHO’s largest platforms for international cooperation on universal health coverage (UHC) and primary health care (PHC). It comprises a broad mix of health experts working hand in hand to promote UHC and PHC by fostering policy dialogue on strategic planning and health systems governance, developing health financing strategies and supporting their implementation, and enabling effective development cooperation in countries.

Our aim is to strengthen country capacities and reinforce the leadership of the Ministry of Health in building resilient and effective health systems in a sustainable manner. We bridge the gap between global commitments and country implementation on the ground.

Since its inception in 2011, the UHC Partnership has expanded ...

District nurses' perspectives on health-promotive and disease-preventive work at primary health care centres: A qualitative study

Health promotion and disease prevention are of utmost importance for sustainable health care and primary health care. District nurses play a key role in primary health care centres, where they meet people suffering from, and/or having risk factors for, non-communicable diseases.

he district nurses described health-promotive endeavours, in line with person-centred care in prioritising building relationships with patients, starting from their lived experience. They spoke of barriers, at both micro and macro levels, to health-promotive/disease-preventive work. These included language barriers, the impact of the media, and the overall organisation of primary health care. 

LIVE: Q&A on primary health care and universal health coverage. #AskWHO

Live with Dr Jim Campbell Director of the Health Workforce Department at the WHO and Shannon Barkley Technical Officer for Primary Health Care at World Health Organization's Special Programme on Primary Health Care from the World Health Organization (WHO) Seventy-fifth World Health Assembly 2022.

EFPC 2022 Conference Ghent. Integrated Community Care: a new opportunity for Primary Care

The European Forum for Primary Care Association is happy to announce its 2022 annual conference with a focus on Integrated Community Care. 

In safe hands: a qualitative study on older adults’ experiences of a tailored primary health care unit

Today’s health care system faces challenges in meeting the needs of older people with multimorbidity. To better cope with these needs, tailored primary health care with geriatric competence and person-centred care has been suggested. The aim of this study was to explore older patients’ experiences of a tailored primary health care unit.

Asynchronous Remote Communication as a Tool for Care Management in Primary Care: A Rapid Review of the Literature

To review the available evidence on asynchronous communication models between primary care professionals and patients in different countries around the world in order to analyse the added value that this model brings to patients and professionals.

Resilience of the primary health care system – German primary care practitioners’ perspectives during the early COVID-19 pandemic

Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective.

Transformations in the landscape of primary health care during COVID-19: Themes from the European region

The COVID-19 pandemic has dramatically impacted primary health care (PHC) across Europe. Since March 2020, the COVID-19 Health System Response Monitor (HSRM) has documented country-level responses using a structured template distributed to country experts. We extracted all PHC-relevant data from the HSRM and iteratively developed an analysis framework examining the models of PHC delivery employed by PHC providers in response to the pandemic, as well as the government enablers supporting these models. Despite the heterogenous PHC structures and capacities across European countries, we identified three prevalent models of PHC delivery employed: (1) multi-disciplinary primary care teams coordinating with public health to deliver the emergency response and essential services; (2) PHC providers defining and identifying vulnerable populations for medical and social outreach; and (3) PHC providers employing digital solutions for remote triage, consultation, monitoring and prescriptions to avoid unnecessary contact.

Social workers coordination in primary healthcare for patients with complex needs: A scoping review

Care coordination has been part of social work for some time. It has been recognized as contributing to care coordination for long-term care for the elderly and mental health but less is known about their contribution in primary care with patients with complex health and social needs. As social workers are increasingly present in primary healthcare, this scoping review aims to provide a synthesis of social workers’ coordination activities for patients with complex needs in primary healthcare.

UN General Assembly Third annual ministerial meeting on Universal Health Coverage: investing in health systems strengthening through a primary health care-oriented approach

The UN General Assembly is the main policy-making organ of the Organization. Comprising all Member States, it provides a unique forum for multilateral discussion of the full spectrum of international issues covered by the Charter of the United Nations.

This year’s discussions will focus on addressing the various challenges the world faces, including the COVID-19 pandemic. These challenges call for global action, and the General Assembly is a critical opportunity for all to come together and chart a course for the future.

As we look to strengthen health systems in the wake of COVID-19, re-orientation of resources toward primary health care and essential public health functions will be critical for the achievement of UHC and the health-related SDGs.

This event, hosted within the UN General Assembly, is organized by the Co-chairs of the Group of Friends of UHC and Global Health (Georgia, Japan, Thailand), WHO, UHC2030, IFRC, UN Foundation ...

Primary health care led recovery from COVID-19 in Costa Rica for underserved communities

Communities in Costa Rica were badly affected by the COVID-19 pandemic. A project in 2020, coordinated by the government of Costa Rica and PAHO/WHO country office showed that community engagement in primary health care could be a path to better tackling wider health and social challenges.

Primary Health Care: The heart of every health system?

This panel discussion opens our ten-part lunchtime seminar series, “Primary Health Care (PHC): The heart of every health system” that will run once a month throughout the 2022/23 academic year. 

The seminar series provides an overview of the key functions and features of PHC; its potential in achieving universal health coverage and its role in global health. Seminars are led by speakers working in a range of settings.

In this opening zoom-based session our panel of cross-country experts will consider what is stopping PHC from being the heart of every health system??? 

Drawing on their own research and experiences, panellists will discuss the role of primary health care within the health system, why primary health care receives relatively little attention from both policymakers and researchers, despite evidence that health systems with strong primary health care health improve population health outcomes at lower cost and consider what should happen next ...

Health alliance for prudent prescribing and yield of antibiotics in a patient-centred perspective (HAPPY PATIENT): a before-and-after intervention and implementation study protocol

Excessive and inappropriate use of antibiotics is the most important driver of antimicrobial resistance. The aim of the HAPPY PATIENT project is to evaluate the adaptation of European Union (EU) recommendations on the prudent use of antimicrobials in human health by evaluating the impact of a multifaceted intervention targeting different categories of healthcare professionals (HCPs) on common community-acquired infectious diseases, especially respiratory and urinary tract infections.

GPs' interest in integrated care for frail older adults and corresponding consulting and prescribing data: qualitative and quantitative analyses of the PAERPA integrated care project

Integrated care pathways can help to avoid unnecessary admissions to hospital and improve the overall quality of care for frail older patients. Although these integrated care pathways should be coordinated by GPs their level of commitment may vary.

Reimagining Primary Health Care Workforce in Rural and Underserved Settings

This Discussion Paper starts at the local level and reimagines primary health care (PHC) and the PHC workforce from the perspective of people living in rural and underserved urban areas of low- and middle-income countries (LMICs). Drawing on research evidence and successful examples, it presents a “start local” health service delivery model, health system design framework, and financing models intended to ensure high-quality local comprehensive PHC is available and accessible to all. Core PHC team members (community health workers, registered nurses, specialist family physicians, and administrators) and other health practitioners are generalists in their disciplines, working together in collaborative practice as the frontline providers of care that responds to the health needs of the population they serve. The most successful model of education and training for local comprehensive PHC is socially accountable, immersive community-engaged education woven into a facilitated education and training pathway starting with recruiting local students from rural ...

Fit for the Future: a new plan for GPs and their patients

General practice is the cornerstone of the NHS, helping around 50 million people in England every year, carrying out 370 million consultations last year. So, when GPs and their patients tell us that general practice is in crisis, we should all be concerned.

In 2022, the RCGP launched Fit for the Future: a new plan for GPs & their patients to put pressure on politicians and decision makers with responsibility for the NHS in England to commit to a bold new plan to provide GPs and patients with the support that they need.

This campaign follows our 2019 Fit for the Future (PDF file, 1.1 MB) vision which set out how, with the right tools and support, we can revitalise and reform general practice by 2030, so that it can continue to deliver world class patient care. Pressures on general practice have since intensified even further and have been exacerbated ...

The Post–COVID-19 Case for Primary Care

Much has been written and discussed about challenges faced by the US health care system, with most of it justifiably concerning the payment system for medical services, and how that leaves an unconscionably large proportion of US residents uninsured or underinsured for quality care. Although payment systems are undoubtedly a challenge and merit substantial conversation, the structure of US health care delivery also leaves much to be desired.

Central to that problem is the paucity of primary care physicians in the US. The approximately 200 000 active primary care physicians in the US represent about 30% of all active physicians, down from 32% about 10 years ago. About 28% of men and 17% of women report they do not have a primary care physician. The Council on Graduate Medical Education recommended an increase in the proportion of primary care physicians to 40%, a recommendation now further from reality than ...

Analysis of Variation in Organizational Definitions of Primary Care Panels: A Systematic Review

Primary care panel size plays an increasing role in measuring primary care providers (ie, physicians and advanced practice providers, which include nurse practitioners and physician assistants) workload, setting practice capacity, and determining pay and can influence the quality of care, access, and burnout. However, reported panel sizes vary widely.

This systematic review aims to identify how panels are defined, the degree of variation in these definitions, the consequences of different definitions of panel size, and research on the strengths of different approaches.

Primary Health Care: The Foundation of Universal Health Coverage

In recognition of Universal Health Coverage Day, Management Sciences for Health convened a group of policymakers and practitioners on December 15, 2022, to examine person-centered primary health care as the foundation of achieving UHC and Sustainable Development Goal 3. Half-way into the lifespan of the SDGs, what needs to be done to ensure that communities are involved in the design of their primary health care systems? What are global best practices for primary health care and what are we learning from them? How can we ensure these experiences are brought to bear as we approach 2030? 

Priorities in integrating primary and secondary care: a multimethod study of GPs

Throughout the world, healthcare policy has committed to delivering integrated models of care. The interface between primary–secondary care has been identified as a particularly challenging area in this regard. To that end, this study aimed to examine the issue of integrated care from general practitioners’ (GPs) perspectives in Ireland.

Adaptation and validation of the Ugandan Primary Care Assessment Tool

WHO European Centre for Primary Health Care: annual report 2022

This report describes the activities of the WHO European Centre for Primary Health Care in 2022. The Centre accelerated face-to-face country support after the wake of the COVID-19 pandemic to support countries in engaging in analysis and diagnosis, developing strategies and policies, building capacity and tracking implementation progress and impact. The Centre delivered intensive support in the countries of the Universal Health Coverage Partnership. The Centre continued to develop policy guidance, publish good practices, have capacity-building activities and policy dialogues and solidified its signature product Let’s Talk Primary Health Care talk show platform. The highlight of 2022 was the launch of two WHO Primary Health Care Demonstration Platforms to facilitate cross-country experience exchange.

Let's Talk Primary Health Care: Managing performance in primary health care

In the next episode of “Let’s Talk PHC” WHO European Centre for Primary Health Care and the researchers on health care performance intelligence from the University of Amsterdam will come together for a live discussion on: actionable primary health care performance measurement and management (data purposes and uses); use of PHC indicators ad part of improvement cycles in policy and practice; capacity strengthening at the national and subnational levels in data collection, analysis, communication and dissemination of results, digitalization of PHC data and clinical engagement and ownership.

Operational Framework for Primary Health Care

The World Health Assembly in resolution WHA72.2 (2019) requests the Director-General inter alia “to develop, in consultation with, and with the involvement of more expertise from, Member States, and in time for consideration by the Seventy-third World Health Assembly, an operational framework for primary health care, to be taken fully into account in the WHO general programmes of work and programme budgets in order to strengthen health systems and support countries in scaling-up national implementation efforts on primary health care”. This operational framework builds on an initial draft that was prepared as part of a technical series to support the Global Conference on Primary Health Care (Astana, 25 and 26 October 2018). It was then revised following expert review, public consultation, civil society consultation, key informant interviews and consultations with Member States.

This operational framework, the related Vision for primary health care in the 21st Century, and associated technical ...

Declaration of Astana

The Global Conference on Primary Health Care in Astana, Kazakhstan in October 2018 endorsed a new declaration emphasizing the critical role of primary health care around the world. The declaration aims to refocus efforts on primary health care to ensure that everyone everywhere is able to enjoy the highest possible attainable standard of health.

The new declaration has renewed political commitment to primary health care from Governments, non-governmental organizations, professional organizations, academia and global health and development organizations. It will be used to inform the UN General Assembly high-level meeting on UHC in 2019. The new declaration was also a chance to commemorate the 1978 Alma-Ata Declaration on Primary Health Care, and reflect on how far we have come and the work that still lies ahead.

The role of PHC in the well-being economy

Well-being economies are those that prioritise equity, sustainability and well-being for current and future generations. This episode of the talk show will bring together European experts to discuss the role of primary health care in the well-being economy – health is both a driver and beneficiary of well-being economies.

Successes and challenges of primary health care in Australia: A scoping review and comparative analysis

Australia has achieved universal health insurance for its population since 1975 - a major step forward for increasing access to primary care (PC). Nevertheless, there are reports of several multi-layered challenges, including inequity, that persist. This analysis aims to undertake a scoping review of the success, explanatory factors, and challenges of Primary Health Care (PHC) in Australia guided by the World Health Organization (WHO)-defined key characteristics of good PC.

Population health management in primary health care: a proactive approach to improve health and well-being: primary heath care policy paper series

Overview

Population health management can play a critical role in strengthening primary health care (PHC) by providing a data-driven, people-centred and proactive approach to managing the health and well-being of a defined population. By identifying subgroups with similar characteristics and needs, population health management can enable PHC providers to move from a one-size-fits-all approach to targeted and tailored interventions that account for the needs of different groups and individuals. By focusing on the social determinants of health and psychosocial needs, population health management can help PHC providers in adopting a holistic and proportionate universalism approach to address health inequalities at the community level. This publication identifies key success factors at the system, organizational and clinical levels to enable population health management in PHC. It includes 12 country examples from across the WHO European Region showing how population health management is used in PHC. The publication provides a set of 16 ...

Models of Integrated Care: The global experience

This Global Experience Paper on Integrated Health Care was developed to provide the Primary Health Care Institute (PHCI) in Libya with insights as it designs and develops its plans to rebuild primary health care (PHC). The findings are informed by a review of recent international literature, and by insights provided by selected international experts. The paper uses the Framework on Integrated, People-Centered Health Services from the World Health Organization to structure the analysis of global experiences. Overall, there is no single model of integration that can or should be adopted in countries seeking to develop primary health care. There is, however, evidence of good practice in designing and developing local, context-specific solutions. Evidence to support effective strategies and policies relevant for conflict-affected situations is scarce. However, there are some common themes and issues relating to the need to rebuild trust in the quality and safety of services; to build from ...

Integrated person- and people-centred primary care for diabetes in low- and middle-income countries: The nurses' perspective on patient needs

The aim of this study was to identify what nurses working in primary care settings perceive as necessary to support the life needs of people with type 2 diabetes. Articulate these needs with the needs expressed by people with diabetes in a previous study. This study demonstrates nurses' important contribution to analysing and designing people-centred care in their community. 

Regional framework on the future of primary health care in the Western Pacific

Regional Framework on the Future of Primary Health Care (PHC) was adopted by Member States at the seventy-third session of the Regional Committee for the Western Pacific in 2022. The framework outlines five key attributes of PHC including people and community-centered, continuous, high-quality and equitable, integrated, and innovative. It highlights five strategic areas of actions needed which pivot around models of service delivery, individual and community empowerment, workforce and provider base, financing, enabling and supportive environment to enable this transformation. It calls on critical health system transformation for the future to achieve Universal Health Coverage and Sustainable Development Goals.

International conference celebrating the 45th anniversary of Alma-Ata and 5th anniversary of Astana declarations

On 23 October WHO/Europe, together with UNICEF and the Government of Kazakhstan, is co-hosting an international conference to celebrate the 45th anniversary of Alma-Ata and 5th anniversary of Astana declarations on primary health care. The conference "Primary health care policy and practice: implementing for better results" will be an official side event of the 73rd session of the WHO Regional Committee for Europe, to be held in Astana, Kazakhstan, in October 2023.

The Conference will:

• take stock of progress implementing the commitments in the Declaration of Astana on primary health care since 2018, including the impact of the COVID-19 pandemic, and demonstrate concrete results;
• shift focus from concepts to action by identifying implementation success factors based on country experiences; and
• identify policies and practices to future-proof primary health-care transformation for moving towards universal health coverage, for greater resilience in the face of emergencies, and better health and well-being. 

Structure ...

Amref International University 1st Primary Healthcare Congress

It has been 45 years since the landmark 1978 Alma-Ata Declaration, which defined Primary Health Care (PHC) as “essential healthcare based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford.”

The goal of PHC is to provide better health services for all, making it an integral part of a country’s health system and the central function for the community’s overall social and economic development. The aim is to achieve the highest possible level of health and well-being, ensuring equitable distribution and a sustainable healthy life without financial burden on patients.

Despite the promulgation of the PHC agenda after the Alma-Ata Declaration, its actualization has remained elusive.  The declaration outlined eight key elements and four pillars necessary to support the actualization of the ...

Primary Health Care the heart of every health system. How do we get there?

A ten-part seminar series, run by the London School of Hygiene & Tropical Medicine, providing an overview of the key features and functions of Primary Health Care (PHC), the potential of PHC in all health systems and its role in achieving universal health coverage. The sessions draw on examples across different settings.

In this final session in the series on “Primary Health Care: The heart of every health system” a panel of cross-country experts will reflect on their key takeaways from the series and consider what more needs to happen to support countries to place PHC at the heart of their health system.

If you would like to submit a question to our panel please submit these here. 

Speakers

• Lakshmi Balaji is a Global Health and International Development leader, and until recently was Chief of PHC and Health Systems Strengthening at UNICEF Headquarters.  
• Dina Balabanova is a Professor of Health Systems ...

Primary health care case studies in the context of the COVID-19 pandemic

Overview

Primary health care measurement framework and indicators: monitoring health systems through a primary health care lens

To continuously strengthen PHC, countries must be able to assess how decisions, actions and investments are addressing the broader determinants of health while improving service coverage, financial risk protection, and ultimately the health of individuals and populations. As countries strive to reorient their health systems around the principles of PHC, this document responds to Member States’ request in resolution WHA72.2 on primary health care for guidance to assess, track and monitor PHC performance to accelerate progress towards UHC and the health-related SDGs. The indicators and monitoring and evaluation conceptual framework presented in this document are based on and support the 14 levers of the Operational framework for primary health care. The indicators and framework have undergone technical review and multiple stages of consultation with countries, civil society, and leading PHC academics and experts.

This document aligns with and advances WHO’s work in monitoring UHC and the SDGs, including ...

Progressing primary health care: a series of country case studies

The 1978 Declaration of Alma-Ata (1) was revolutionary. Many countries, the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and other organizations had been pursuing strategies to provide primary health care (PHC) for years (2). However, Alma-Ata made PHC central to health care policy and practice. In a world in which resources had long been focused on “vertical” health programmes, expanding the focus of health care was a novel approach for the global health community. Since this declaration, efforts to improve health have increasingly been framed in terms of building, strengthening or realigning the systems that contribute to a more expansive notion of health for the entire population.

In 2018, in support of the Global Conference on Primary Health Care and the Declaration of Astana, WHO commissioned a series of case studies on various countries that have delivered PHC reforms over the past four decades. These case ...

World leaders commit to redouble efforts towards universal health coverage by 2030

Today, 21 September 2023, at the United Nations (UN) General Assembly High-Level Meeting, world leaders have approved a new Political Declaration on “Universal Health Coverage (UHC): expanding our ambition for health and well-being in a post-COVID world”.  

The declaration is hailed as a vital catalyst for the international community to take big and bold actions and mobilize the necessary political commitments and financial investments to attain the UHC target of the Sustainable Development Goals (SDGs) by 2030.

The UHC target measures the ability of countries to ensure that everyone receives the health care they need, when and where they need it, without facing financial hardship. It covers the full continuum of key services from health promotion to prevention, protection, treatment, rehabilitation and palliative care. Alarmingly, global progress towards UHC has been largely stagnating since 2015, before stalling in 2019.

The urgency of the declaration is evident in the staggering statistics ...

A vision for primary health care in the 21st century

In 1978 world leaders, international organizations and health authorities gathered in Alma-Ata (now Almaty), Kazakhstan, and released the Declaration of Alma-Ata on Primary Health Care, which remains a landmark document in the history of global health. The Alma-Ata Declaration established a standard of public commitment to making community-driven, quality health care accessible, both physically and financially, for all. This was the forerunner of the Global Strategy for Health for All by the Year 2000 that was pursued by WHO and its partners for the rest of the 20th century, and of Sustainable Development Goal (SDG) 3: “Ensure healthy lives and promote well-being for all at all ages” by 2030.

A Vision for Primary Health Care in the 21st Century provides the rationale for and foundation of the Astana Declaration, with its continued political focus on the right to integrated, quality, personal and population-level primary care; on health as a multisectoral ...

Integrated care for older people with cancer: a primary care focus

Estimates from a 2023 study indicate that cancer will continue to grow as a leading cause of health and economic burden alongside global population ageing.

Consequently, health-care providers, including primary care teams, will increasingly face substantial challenges in caring for older people with cancer who have evolving, complex, and specific needs. More than 60% of new cancer diagnoses occur in adults aged 65 years and older in high-income countries, underpinning the importance of empowering primary health-care providers (including general practitioners, community nurses, allied health professionals, and pharmacists) to provide high-quality care to this at-risk population.

Nevertheless, geriatric oncology remains peripheral in the awareness of primary health-care providers. Therefore, raising awareness of the growing importance of geriatric oncology and fostering collaboration between primary health-care providers and oncogeriatric teams is essential to ensure optimal care for older people with cancer.

Implementation Toolbox to Document and Analyze Primary Health Care Innovations

Implementation science is a multidisciplinary field that focuses on studying and promoting effective strategies for translating evidence-based interventions (EBIs) into routine practice to improve outcomes in real-world settings. It has been increasingly used to document and assess interventions, as it helps to make sense of how, when, where, and why research results and EBI are, or are not, being successfully used. When compared to traditional project design, implementation, and management of health care interventions, implementation science can add value by addressing the specific complexities and challenges associated with implementing and scaling up these interventions. More specifically, it helps to analyze and understand the contextual factors, stakeholder dynamics, and system-level barriers that can hinder the successful adoption and integration of health care interventions. In this sense, by integrating implementation science principles the World Bank can tailor strategies, develop robust implementation plans, and leverage evidence-based practices to overcome implementation problems, which is ...