Intentionally designing the system to adapt and respond to health needs and trends within the local population. It requires leaders to regularly generate, collect and analyze information on population health status and needs; appropriately use this information to set and implement priorities; and continually monitor, re-assess, and adapt as needed. This process should consider social determinants of health and a country's epidemiological, political, socioeconomic, and environmental context, all with a focus on equity.
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Timeliness
The ability of the health system to provide primary care services to patients when they need them, with acceptable and reasonable wait times and at days and times that are convenient to them.
The ability of the health system to provide primary care services to patients when they need them, with acceptable and reasonable wait times and at days and times that are convenient to them.
Efficiency refers to the ability of a health system to attain its desired objective(s) with the available resources, while minimizing waste and maximizing capacities to deliver care to those who need it.
The ability of a health system to attain its desired objective(s) with the available resources, while minimizing waste and maximizing capacities to deliver care to those who need it.
People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases.
People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases. This involves engaging with people, families, and communities as equal partners in promoting and maintaining their health - including through communication, trust, and respect for preferences, as well as ongoing education and support so that they can participate in health care decisions.
The capacity of a primary care system to serve as the first point of contact, or a patient's entry point to the health system, for most of a person's health needs.
The capacity of a primary care system to serve as the first point of contact, or a patient's entry point to the health system, for most of a person's health needs.
Coordination of care refers to the system's ability to oversee and manage patient care over time and across levels of care to ensure appropriate follow-up, minimize the risk of error, and prevent complications.
The system's ability to oversee and manage patient care throughout the course of treatment and across various sites of care to ensure appropriate follow-up, minimize the risk of error, and prevent complications. Coordination of care happens across levels of care and over time, and often requires proactive outreach on the part of health care teams and consistent tracking and communication of progress.
Continuity is the degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context.
The degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context. This requires fostering trusted relationships between health care providers and patients over time (relational continuity), ensuring information is communicated from one event to the next (informational continuity), and ensuring the process is managed in a timely, complementary, and effective way across providers (management continuity).
The provision of holistic and appropriate care across promotive, preventive, curative, rehabilitative, chronic and palliative service needs.
The provision of holistic and appropriate care across a broad spectrum of health needs, ages, and solutions. Comprehensive primary health care is able to address a majority of promotive, preventive, curative, rehabilitative, chronic and palliative service needs.
Priority setting in the national health strategic plan/policy is based on data and evidence, and is measured against key criteria (see technical specifications in metadata)
Related Concepts
Delivering high-quality primary health care requires many elements of the health system working effectively together. This mapping explores how different concepts with the framework relate to one another.
Upstream elements are those that are required to develop or improve a particular concept. Absence or poor performance of an upstream element is expected to negatively impact the performance of the concept of focus.
Complementary elements are those where improvements or developments in this area will be mutually beneficial to the concept of focus but not required for improvement.
UPSTREAM CONCEPTS
COMPLEMENTARY CONCEPTS
UPSTREAM SUBDOMAINS
Adjustment to Population Health Needs
COMPLEMENTARY SUBDOMAINS
Funding & Allocation of Resources
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Understaning the financial capacity for PHC funding and cost-effectiveness measures helps to inform priority setting including resource distribution.
Information & Technology
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Priority setting, a component of Adjustment to Population Health Needs, relies on the availability of diverse sources of surveillance data on emerging and existing population health needs. This up-to-date health information also helps to guide innovation and learning efforts and are essential for monitoring, evaluating, and scaling innovations.
Multi-Sectoral Approach
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The innovation and learning needed for adjustment to population health needs is a multi-directional process that relies on shared learning and input from stakeholders across all levels of the system. Encouraging broader social participation in the decision making process (including community-based representation and a multisectoral approach) helps to strengthen accountability across sectors and forge collaborative partnerships for equitable and sustainable initiatives.
Policy and Leadership
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Strong governance structures, such as PHC policies, leadership commitment, and dedicated budgets, help to establish and enforce participatory priority setting mechanisms that help PHC structures adjust to population health needs.
Purchasing & Payment Systems
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Understanding the financial capacity of Purchasing & Payment Systems can help inform priority setting across the PHC system.
Management of Services
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Effective management supports the adoption and adaptation of novel and ongoing quality improvement initiatives for innovation and learning activities at the facility level. Performance measurement and management also enables the monitoring and evaluation of innovations at the facility level.
Organization of Services
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Quality management infrastructure, a component of organization of services, creates and enables a systems environment for improvement, which is part and parcel of building a culture of innovation and learning.
People-Centeredness
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Understanding innovation and learning from the perspective of the patient is critical to designing innovations that meet patient needs and ultimately enable the design of person-centered health systems.
Population Health Management
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Priority setting exercises at the national level should both inform and be informed by local priorities. Additionally, stakeholder engagement from the local level is an important tool for making innovations responsive to existing and emerging social concerns and priorities relevant to the sub-national level.
Improvement Strategies
Each PHCPI Improvement Strategy is designed to help decision-makers begin to plan and enact reforms within their own context by providing additional resources and evidence on the topic, as well as practical recommendations for action.
Interested in understanding how this topic intersects with investment opportunities from major funding streams? The Global Frameworks Mapping provides a starting point to help identify and make connections between key PHC topics, relevant funding initiatives, and investment cases.
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Walking the Talk: Reimagining Primary Health Care After COVID-19
"Outcome 1: Midwifery - Midwives deliver right based quality sexual and reproductive health information and services that are women centered, equitable, accountable, and accessible."
Outcome 3: MPDSR: Causes of maternal and perinatal deaths are identified and addressed through MPDSR programmes.
"Result Area 9: ""Systems for health and social protection schemes that supporrt wellness, livelihood, and enabling environments for people living with, at risk of, or affected by HIV to reduce inequalities and allow them to live and thrive"" "
"Cross-cutting Issue 3: Data, science, research, and innovation"