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J Gen Intern Med. 2017 May;32(5):566-571. doi: 10.1007/s11606-016-3898-5. Epub 2016 Dec 9.

Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries.

Author information

1
Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, Third Floor East, Boston, MA, 02215, USA. abitton@partners.org.
2
Harvard Medical School, Boston, MA, USA. abitton@partners.org.
3
Ariadne Labs, Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, 401 Park Drive, Third Floor East, Boston, MA, 02215, USA.
4
The World Bank Group, Washington, DC, USA.
5
The Bill & Melinda Gates Foundation, Seattle, WA, USA.
6
World Health Organization, Geneva, Switzerland.
7
Results for Development Institute, Washington, DC, USA.
8
Harvard Medical School, Boston, MA, USA.

Abstract

Primary health care (PHC) has been recognized as a core component of effective health systems since the early part of the twentieth century. However, despite notable progress, there remains a large gap between what individuals and communities need, and the quality and effectiveness of care delivered. The Primary Health Care Performance Initiative (PHCPI) was established by an international consortium to catalyze improvements in PHC delivery and outcomes in low- and middle-income countries through better measurement and sharing of effective models and practices. PHCPI has developed a framework to illustrate the relationship between key financing, workforce, and supply inputs, and core primary health care functions of first-contact accessibility, comprehensiveness, coordination, continuity, and person-centeredness. The framework provides guidance for more effective assessment of current strengths and gaps in PHC delivery through a core set of 25 key indicators ("Vital Signs"). Emerging best practices that foster high-performing PHC system development are being codified and shared around low- and high-income countries. These measurement and improvement approaches provide countries and implementers with tools to assess the current state of their PHC delivery system and to identify where cross-country learning can accelerate improvements in PHC quality and effectiveness.

KEYWORDS:

global health; health policy; measurement; primary care

PMID:
27943038
PMCID:
PMC5400754
DOI:
10.1007/s11606-016-3898-5
[Indexed for MEDLINE]
Free PMC Article

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