Primary Health Care

What is Primary Health Care? The concept of primary health care has been repeatedly reinterpreted and defined over the years since 1978, resulting in confusion about the term and its application. A clear and simple definition to facilitate the coordination and guidance of future efforts on primary health care at the global, national and local levels is as follows: "Primary health care is a whole-of-society approach to health with the goal of ensuring that health and well-being are reached and distributed equitably by focusing on meeting people's needs as quickly as possible and along the path of providing services from health promotion and disease prevention to treatment, rehabilitation and palliative care, provided in a way that is as close to their daily living environment as possible."WHO and the United Nations Children's Fund (UNICEF) A vision for primary health care in the 21st century: Towards universal health coverage and the Sustainable Development Goals. Primary health care entails three interdependent and mutually reinforcing elements, including: integrated and comprehensive health services that include primary care as well as public health goods and functions as pivotal elements; Primary health care is rooted in a commitment to social justice, equity, solidarity and participation. It is based on the recognition that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without discrimination. For UHC to be truly inclusive, it is necessary to shift from health systems designed in a way that is centred around diseases and institutions to ones that are designed for and work with people. Primary health care requires governments at all levels to emphasize the importance of working beyond the health sector to take a whole-of-government approach to health, including integrating health into all policies, and a strong focus on equity and the implementation of comprehensive interventions throughout an individual's lifetime. Primary health care addresses the broader determinants of health, focuses on the holistic and interrelated aspects of physical, psychological, and social health and well-being, and provides a person with comprehensive care services to meet their health needs throughout life, without only treating a range of specific diseases. Primary health care ensures that people have access to comprehensive care services, from health promotion and prevention to treatment, rehabilitation and palliative care – delivered in a way that is as close to their daily living environment as possible. Why is primary health care important? Member States have committed to the renewal and implementation of primary health care as the cornerstone of any sustainable health system that provides universal health coverage and achieves the Sustainable Development Goals (SDGs) related to health and health security. Primary health care provides the "programmatic engine" needed to achieve universal health coverage, health-related Sustainable Development Goals and health security. This commitment has been codified and reaffirmed in the Astana Declaration, the accompanying World Health Assembly Resolution 72/2, the Global Reports on UHC Monitoring, and the UN General Assembly's High-Level Declarations on UHC. Universal health coverage, health-related Sustainable Development Goals and health security goals are ambitious, but achievable. Progress in this area must be accelerated, because primary health care provides the means to do so. Primary health care is the most comprehensive, equitable, effective, cost-effective and efficient approach to promoting people's physical and mental health, as well as their social well-being. There is a steady increase in evidence on the impact achieved at scale thanks to investment in primary health care worldwide, especially in times of crisis such as the COVID-19 pandemic. Investments in primary health care worldwide improve equity and access, health-care performance, accountability for health systems, and health outcomes. While some of these factors are directly related to the health system and access to health services, there is clear evidence that there are a wide range of factors that are not part of health services and play a critical role in shaping health and well-being. These factors include social protection, food systems, education, and environmental factors, among others. Primary health care is also indispensable to strengthen the resilience of health systems to crisis situations and enable them to proactively detect early signs of epidemics and increase their preparedness to act early in response to sudden increases in demand for services. Although the evidence is still being developed, there is widespread recognition that primary health care is the "front" of the health system, laying the foundation for strengthening essential public health functions to address public health crises such as the COVID-19 pandemic. WHO Response WHO is helping countries reorient their health systems towards primary health care as a key means of achieving universal health coverage, Sustainable Development Goal 3 and health security. Health systems should be appropriate to the people, the context and the purpose for which they are being prepared. Strengthening the health system involves strengthening health governance and financing; strengthening the health workforce; gender equality and gender rights; information systems; quality of care and patient safety; safeguarding maternal, newborn, child and adolescent health for healthy age; sexual and reproductive health; medicines and medical supplies; emergency preparedness, response and recovery; and action to combat communicable and noncommunicable diseases, among others. WHO has identified the following three strategic areas of action to strengthen primary health care worldwide: 1. Provide a "comprehensive" mechanism to support the implementation of primary health care in Member States, tailored to the country's context and priorities. This includes putting the operational framework for primary health care into place, leveraging investment opportunities from the COVID-19 response, and building better primary health care-based health systems as recovery efforts are underway. This core function is driven by and builds on and builds on work done and existing experiences from countries and regions around the world. 2. Develop evidence and innovations geared towards the provision of primary health care with a greater focus on the left behind. This work builds on existing implementation evidence, guidance on best practices and implementation solutions, experiences from successful countries, and published literature to catalyze innovative solutions. Key target achievements include monitoring and measurement guidance to assess progress in the provision of primary health care in countries, and the subsequent preparation of a global progress report Progress in the provision of primary health care, as well as innovative capacity-building efforts within the framework of the WHO Academy. 3. Strengthen the process of renewing primary health care by taking a leading role in policy-making, advocacy and strategic partnerships with governments, non-governmental organizations, civil society organizations, development partners, sister UN agencies, donors, and other stakeholders at the global, regional and country levels. Among other initiatives, an external strategic advisory group on primary health care will be formed to advise WHO on the renewal of primary health care worldwide, and will also establish a Primary Health Care Award in recognition of outstanding practices in primary health care at the global level, and will encourage new partnerships on primary health care and collaborative networks of new stakeholders, such as young health leaders, members of parliament and civil society groups at large.