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Assessing primary health care
Turning a political commitment into reality on the ground begins with a thorough, evidence-based understanding of the existing system. In other words, before taking action, countries will need to carry out an assessment of the current state of primary health care. There are several tools available to carry out such an evaluation.
In WHO’s Eastern Mediterranean Region, for example, existing indicators have been adapted to regional realities to create the Primary Health Care Measurement and Improvement (PHCMI) initiative, which enables countries in the region to
evaluate existing health systems and approaches.
The Primary Health Care Performance Initiative (PHCPI), through its Vital Signs Profiles,
also provides a great deal of data to assist countries in evaluation and decision-making.
Once the data is available, and the decisions are made, it is time for implementation. To that end, WHO has, with the support of partners, created the Primary Health Care Operational Framework. This document outlines several primary health care levers which countries can use to guide the move to a primary health care model.
Monitoring primary health care
Countries that monitor progress on primary health care are better equipped to build health systems that meet their population’s needs.
To continuously strengthen primary health care, 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.
WHO and UNICEF jointly released the landmark Primary health care measurement framework and indicators: monitoring health systems through a primary health care lens, the first-ever globally normative and endorsed primary health care measurement and monitoring framework, and the official measurement framework in support of the Declaration of Astana and Operational Framework for Primary Health Care.
As countries strive to reorient their health systems around the principles of primary health care, this Framework responds to Member States’ request to monitor primary health care performance to accelerate progress towards universal health coverage and the other health-related Sustainable Development Goals.
Improving primary health care
Primary health care encompasses a broad spectrum of areas and activities, including (but not limited to): rehabilitation, health workforce, mental health, digital health, sexual and reproductive health, and quality, among others. To assist countries and health professionals to understand how each of these areas is implicated in primary health care, WHO has produced the Technical Series on Primary Health Care.
Country experiences and lessons are documented in WHO’s special series of stories from the field.
WHO has also developed a Primary Health Care Case Study Compendium, which presents evidence on the effective implementation of the several levers of the WHO-UNICEF Operational Framework for Primary Health Care:
Core strategic levers
1. Political commitment and leadership
2. Governance and policy frameworks
3. Funding and allocation of resources
4. Engagement of communities and other stakeholders
Operational levers
5. Models of care
6. Primary health care workforce
7. Physical infrastructure
8. Medicines and other health products
9. Engagement with private sector providers
10. Purchasing and payment systems
11. Digital technologies
for health
12. Systems for improving the quality of care
13. Primary health care-oriented research
14. Monitoring and evaluation