The systems and innovations used for collecting, processing, storing, and transferring health data and information. This information is necessary for planning, managing, delivering, and improving high quality health services, including effective surveillance systems..
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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.
Percentage of facilities with a system of electronic capture of patient-level health data (patient records system) with following attributes (see technical specifications in metadata)
Country has an effective surveillance system based on the average of two SPAR indicators on early warning function (C6.1) and mechanisms for event management (C6.2) (see technical specifications in metadata)
Country can generate regular, comprehensive, high-quality, nationally representative statistics with equity dimensions on population health status, health-related behaviours and risk factors, access to health interventions and out-of-pocket spending on health
1. Percentage of births that are registered2. Proportion of children under 5 years of age whose births have been registered with a civil authorityBoth these definitions are used. Definition 1 is used for countries that have robust CRVS systems. For countries with CRVS systems that are not mature, a survey-based method has been proposed to calculate completeness of birth registration. Both these methods are valid.
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Functional national human resource information system and national health workforce accounts
Percentage of facilities using single, comprehensive patient records that provide a longitudinal health history of patients across time and for all health conditions and which includes key components (see technical specifications in metadata)
Percentage of facilities that use information systems for capturing and reporting comprehensive patient and facility data and report according to district and/or national requirements within the required deadline.
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
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Physical Infrastructure
Laboratories and clinics are typically the main platform for event-based and syndromic surveillance systems.
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Policy and Leadership
Legislation and national policies should determine establishment and operation of surveillance systems; alignment with global recommended surveillance standards; PHC policies on public health emergency plans and resource mobilization. They should also be supportive of digital technologies and coordinated information infrastructure promote comprehensive, interoperable information systems.
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Organization of Services
Laboratories and clinics are typically the main platform for event-based and syndromic surveillance systems. The functional capacity of these laboratories and clinics are determined by the organization of services.
Information & Technology
COMPLEMENTARY SUBDOMAINS
Adjustment to Population Health Needs
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Participatory priority setting supports the identification of surveillance priorities to be monitored for managing both the delivery of health services and status of population health.
Funding & Allocation of Resources
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Changes to spending on PHC as a whole can impact the financing available to PHC information systems and techonological investments, however it is not necessary that spending on PHC alone would impact this input.
PHC Workforce
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Surveillance relies on the availability of a fully competent, coordinated, and multidisciplinary health workforce responsible for public health surveillance and response at all levels of the health system.
Purchasing & Payment Systems
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Purchasing & Payment systems often impact the acquisition of and investment into necessary Information & Technology, however it is not necessary that spending on PHC alone would impact this input
Management of Services
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Given some facility funding is decentralized, it can be complimentary to the maintainence of and building of information systems. Additionally, management of servicse allows for better, more strategic and efficient use of funds at the facility level. Finally, quality management infrastructure at the facility level helps to ensure data quality standards are in place, regulated, and enforced.
Population Health Management
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Local priority setting enables the identification of local burden of disease and population health needs that will merit surveillance; and it is also an important platform for data collection. Additionally, community engagement helps to ensure that information and communicaiton technologies are suitable to the local context.
Service Availability & Readiness
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Because many stakeholders are involved in surveillance, it is important to facilitate trust among different levels of the health system to improve communication and accuracy of information gathered. Additionally, surveillance relies on the availability of a fully competent, coordinated, and multidisciplinary health workforce responsible for public health surveillance and response at all levels of the health system.
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
Goal 2A: Help countries extend immunisation services to regularly reach under-immunised and zero-dose children to build a stronger primary health care platform
"Outcome 2: EmONC: Referral maternity facilities are staffed with skilled attendants at birth and monitored to deliver quality and accessible essential sexual and reproductive healthcare, including EmONC. "
Outcome 3: MPDSR: Causes of maternal and perinatal deaths are identified and addressed through MPDSR programmes.
Outcome 4: Quality sexual and reproductive health information and services are accessible to prevent and treat obstetric fistula and other obstetric morbidities.
