Key facts
- Over 1.6 billion people worldwide were at risk of being pushed into poverty or further impoverished due to out-of-pocket health spending of 10% or more of their household budget in 2022.
- Scaling up primary health care (PHC) interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.
- An estimated 75% of the projected health gains from the Sustainable Development Goals could be achieved through PHC.
- Achieving the targets for PHC requires an additional investment of around US$ 200 to US$ 328 billion a year for a more comprehensive package of health services.
Overview
The concept of PHC has been repeatedly reinterpreted and redefined in the years since 1978leading to confusion about the term and its practice. A clear and simple definition has been developed to facilitate the coordination of future PHC efforts at the globalnational and local levels and to guide their implementation: "PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatmentrehabilitation and palliative careand as close as feasible to people’s everyday environment."
PHC entails three inter-related and synergistic componentsincluding: comprehensive integrated health services that embrace primary care as well as public health goods and functions as central pieces; multi-sectoral policies and actions to address the upstream and wider determinants of health; and engaging and empowering individualsfamilies and communities for increased social participation and enhanced self-care and self-reliance in health.
PHC is rooted in a commitment to social justiceequitysolidarity 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 distinction.
For universal health coverage (UHC) to be truly universala shift is needed from health systems designed around diseases and institutions towards health systems designed for peoplewith people. PHC requires governments at all levels to underscore the importance of action beyond the health sector in order to pursue a whole-of government approach to healthincluding health-in-all-policiesa strong focus on equity and interventions that encompass the entire life-course.
PHC addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physicalmental and social health and well-being. It provides whole-person care for health needs throughout the lifespannot just for a set of specific diseases. Primary health care ensures people receive quality comprehensive care – ranging from promotion and prevention to treatmentrehabilitation and palliative care – as close as feasible to people’s everyday environment.
Why is primary health care important?
Member States have committed to primary health care renewal and implementation as the cornerstone of a sustainable health system for UHChealth related Sustainable Development Goals (SDGs) and health security. PHC provides the programmatic engine for UHCthe health-related SDGs and health security. This commitment has been codified and reiterated in the Declaration of Astanathe accompanying World Health Assembly Resolution 72/2Global Monitoring Reports on UHCand the United Nations General Assembly high-level declarations on UHC. UHCthe health-related SDGs and health security goals are ambitious but achievable. Progress must be urgently acceleratedand PHC provides the means to do so.
PHC is the most inclusiveequitablecost-effective and efficient approach to enhance people’s physical and mental healthas well as social well-being. Evidence of wide-ranging impact of investment in PHC continues to grow around the worldparticularly in times of crisis such as the COVID-19 pandemic.
Across the worldinvestments in PHC improve equity and accesshealth-care performanceaccountability of health systemsand health outcomes. While some of these factors are directly related to the health system and access to health servicesthe evidence is clear that a broad range of factors beyond health services play a critical role in shaping health and well-being. These include social protectionfood systemseducation and environmental factorsamong others.
PHC is also critical to make health systems more resilient to situations of crisismore proactive in detecting early signs of epidemics and more prepared to act early in response to surges in demand for services. Although the evidence is still evolving there is widespread recognition that PHC is the so-called front door of the health system and provides the foundation for the strengthening of the essential public health functions to confront public health crises such as COVID-19.
WHO response
WHO is helping countries to reorient their health systems towards PHC as a key means towards achieving UHCSDG3 and health security. Health systems should be fit for peoplefit for context and fit for purpose. Health system strengthening involves strengthening of health governance and financing; the health workforce; genderequity and rights; information systems; quality and patient safety; maternalnewbornchild and adolescent health through to healthy ageing; sexual and reproductive health; medicines and medical supplies; emergency preparednessresponse and recovery; work on communicable and non-communicable diseasesamong others.
WHO has identified three strategic areas of work to strengthen PHC worldwide.
- Providing a one-stop mechanism for PHC implementation support to Member Statestailored to country context and priorities. This includes putting into action the Operational Framework for PHC and capitalizing on investment opportunities from the COVID-19 responsebuilding back better PHC-based health systems during recovery efforts. This core function is driven by and builds on existing work and experiences from countries and regions from across the world.
- Producing PHC-oriented evidence and innovationwith a sharper focus on people left behind. This work is based on existing implementation evidencebest practice guidance and implementation solutionsexpertise from successful countriesand literature published to drive innovative solutions. Key deliverables include monitoring and measurement guidance to assess PHC progress in countries andsubsequentlya global report on PHC progressas well as an innovative capacity building effort as part of the WHO Academy.
- Promoting PHC renewal through policy leadershipadvocacy and strategic partnerships with governmentsnon-governmental organizationscivil society organizationsdevelopment partnersUN sister agenciesdonors and other stakeholders at globalregional and country levels. Among other initiativesthis workstream will establish an external Strategic Advisory Group on PHC to advise the WHO on PHC renewal worldwideit will create a PHC award for recognizing PHC excellence globallyand it will promote new PHC partnerships and collaborative networks incorporating new stakeholders such as young health leadersparliamentarians and civil society at large.