Data and numbers
- More than 1 billion people around the world are at risk of falling into poverty due to the direct health care costs they face, which account for 10% or more of their household budget.
- Scaling up primary health care interventions in low- and middle-income countries could save 60 million lives and increase life expectancy by 3.7 years by 2030.
- Most of the essential interventions (90%) for universal health coverage can be delivered using a primary health care approach.
- It is estimated that primary health care can achieve 75% of the health progress foreseen in the Sustainable Development Goals.
- To achieve the goals in terms of primary health care, an additional investment of approximately between US$ 200,000 and US$ 328,000 million per year is required to be able to offer a more complete package of health services.
What is primary health care?
The concept of APS has been reinterpreted and redefined multiple times since 1978, leading to confusion about its meaning and practice. To coordinate future PHC work at global, national and local levels, and to guide its implementation, a clear and simple definition has been developed:
“PHC is a whole-of-society approach to health that aims to ensure the highest possible level of health and well-being and its equitable distribution through care focused on the needs of people as early as possible throughout along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as possible to people’s everyday environment. WHO and UNICEF. A vision for primary health care in the 21st century: Towards UHC and the SDGs.
PHC has three components that are interdependent and synergistic, namely: a set of integrated and comprehensive health services that encompass primary care and public health goods and functions as central elements; different multisectoral policies and actions aimed at addressing the broader general determinants of health; and mobilizing and empowering individuals, families and communities to achieve greater social participation and improve health self-care and self-sufficiency.
The APS has its roots in the commitment to social justice, equity, solidarity and participation. It is based on the recognition that the enjoyment of the highest level of health that can be achieved is one of the fundamental rights of every human being without distinction.
For universal health coverage (UHC) to be truly universal, health systems must move from their current disease- and institution-based design to one that is people-based and delivered with their help. PHC requires governments at all levels to emphasize the importance of taking action beyond the health sector to implement a whole-of-government health methodology that includes health in all policies, pays special attention to equity and interventions that span the entire life course.
PHC takes into account the broader determinants of health, focusing on the general and interrelated aspects of physical health, mental health, social health and well-being. It offers comprehensive care for health needs throughout the course of life and not just for a specific series of diseases. Primary health care guarantees people comprehensive quality care – from promotion and prevention to treatment, rehabilitation and palliative care – as close as possible to their usual places.
Why is primary health care important?
Member States have committed to renew and implement primary health care as the cornerstone of a sustainable health system to achieve UHC, the health-related Sustainable Development Goals (SDGs) and health security. The PHC is the “programmatic engine” to achieve UHC, the SDGs related to health and health security. This commitment has been formulated and reiterated in the Astana Declaration, the related World Health Assembly resolution 72.2, the global monitoring reports on universal health coverage and the high-level declarations of the United Nations General Assembly on the CSU. The UHC, health-related SDGs and health security goals are ambitious but achievable. Progress needs to be made urgently, and APS provides the means to do so.
PHC is the most inclusive, equitable, cost-effective and effective approach to improving people’s physical and mental health, as well as their social well-being. There is growing evidence around the world of the broad impact of investing in PHC, particularly in times of crisis such as the COVID-19 pandemic.
Globally, investments in PHC improve equity and access in relation to health services, health care performance, health systems accountability, and health outcomes. Although some of these factors are directly related to the health system and access to its services, increasing evidence shows that a wide range of factors beyond health services play a fundamental role in shaping health. and well-being. For example, social protection, food systems, education and environmental factors.
PHC is also essential for health systems to be more resilient in crisis situations, more dynamic in detecting the first signs of epidemics, and better prepared to act early in response to increases in demand for services. . Although data is still lacking, there is broad consensus that PHC is the “main door” of the health system and the basis for strengthening essential public health functions in the face of crises such as COVID-19.
WHO response
WHO is helping countries reorient their health systems towards PHC as a key means to achieve UHC, SDG 3 and health security. Health systems must be appropriate for the people, the context and the purpose for which they were designed. Strengthening the health system involves strengthening, among other things: health governance and financing; the provision of health personnel; respect for gender, equity and human rights issues; information systems; the quality of care and patient safety; the health of the mother, newborn, child and adolescent through to healthy aging; sexual and reproductive health; medications and medical supplies; emergency preparedness, response and recovery; the fight against communicable and non-communicable diseases.
WHO has defined three strategic areas of work to strengthen PHC around the world:
- Provide a ‘one-stop shop’ support service to Member States for the implementation of PHC based on their context and priorities. This involves putting in place the operational framework for PHC and taking advantage of investment opportunities in the response to the COVID-19 pandemic, applying the principle of rebuilding to improve PHC-based health systems during recovery efforts. That central function is inspired and supported by the work and experiences of countries and regions around the world.
- Generate innovative solutions and evidence on PHC, paying greater attention to people left behind. This work builds on existing application evidence, best practice guidance and implementation solutions, positive country experiences and published literature to drive innovative solutions. Key deliverables include guidance on monitoring and measurement to assess PHC progress in countries, followed by a global report on PHC progress, as well as innovative capacity-building efforts organized by the Academy of The OMS.
- Promote PHC renewal through policy leadership, advocacy and strategic partnerships with governments, non-governmental organizations, civil society organizations, development partners, sister United Nations agencies, donors and other stakeholders at global, regional and country levels. Among other initiatives, an external strategic advisory group on PHC will be established to advise WHO on the renewal of PHC worldwide, a PHC award will be created to recognize excellence in PHC globally, and new initiatives will be promoted. associations and collaborative networks in the field to integrate new stakeholders, such as young health leaders, parliamentarians and civil society agents in general.
