title: Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries.
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.
authors.affiliation: 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.|Harvard Medical School, Boston, MA, USA. abitton@partners.org.
authors.forename: Asaf
authors.initials: A
authors.lastname: Bitton
authors.affiliation: 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.
authors.forename: Hannah L
authors.initials: HL
authors.lastname: Ratcliffe
authors.affiliation: The World Bank Group, Washington, DC, USA.
authors.forename: Jeremy H
authors.initials: JH
authors.lastname: Veillard
authors.affiliation: The Bill & Melinda Gates Foundation, Seattle, WA, USA.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Kress
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Shannon
authors.initials: S
authors.lastname: Barkley
authors.affiliation: Results for Development Institute, Washington, DC, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Kimball
authors.affiliation: The World Bank Group, Washington, DC, USA.
authors.forename: Federica
authors.initials: F
authors.lastname: Secci
authors.affiliation: The Bill & Melinda Gates Foundation, Seattle, WA, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Wong
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Lopa
authors.initials: L
authors.lastname: Basu
authors.affiliation: Results for Development Institute, Washington, DC, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Taylor
authors.affiliation: The World Bank Group, Washington, DC, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Bayona
authors.affiliation: The Bill & Melinda Gates Foundation, Seattle, WA, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Results for Development Institute, Washington, DC, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Lagomarsino
authors.affiliation: 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.|Harvard Medical School, Boston, MA, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Hirschhorn
mesh_terms: D003695:Delivery of Health Care / Q000191:economics* / Q000379:methods / Q000639:trends; D019049:Developed Countries / Q000191:economics*; D003906:Developing Countries / Q000191:economics*; D006801:Humans; D011203:Poverty / Q000191:economics* / Q000639:trends; D011320:Primary Health Care / Q000191:economics* / Q000379:methods / Q000639:trends
keywords: global health; health policy; measurement; primary care