A foundational approach to primary care service delivery. It prioritizes proactive community outreach and engagement, from involving people in their own health care decisions to involving communities in PHC planning and decision-making at the local level. In some places, this also means assigning every person to a primary care team that is responsible for supporting their health and well-being.
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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.
There is a system to ensure local service planning is informed by community voices including vulnerable groups, including key activities (see technical specification in metadata)
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Collaboration between facility and community-based service providers
Percentage of primary care facilities and first-referral hospitals that have established formal linkages with community-based service providers (including community health workers)
An empanelment system exists and is measured by 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
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PHC Workforce
Successful empanelment requires a sufficient and well trained workforce to empanel patients to. Provider supply is a crucial component in determining panel size and composition. There must also be an adequate supply of appropriately trained, reliable, and available community-based providers to effectively provide community-based proactive outreach and care.
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Service Availability & Readiness
Understanding which specific services are offered and available in relevant health care settings is critical prior to engaging in proactive population outreach and prior to empaneling patient populations to the appropriate facilities.
Population Health Management
COMPLEMENTARY SUBDOMAINS
Adjustment to Population Health Needs
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National priority setting exercises that allow flexibility and encourage adaptation at a local level help to facilitate local priority setting.
Information & Technology
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Information systems can be complementary to successful local priority setting with the existence of information systems that can effectively collect, track, and report data that is relevant to the local level. Successful empanelment can be supported by information systems with broad, fundamental capacities to identify, stratify, and track a given patient population. Surveillance systems provide data that supports identification of populations in need of proactive population outreach services. While I&T is useful to population health management efforts, many efforts can be implemented in some capacity without a robust technology or information system.
Multi-Sectoral Approach
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Social accountability provides a mechanism for citizens and civil society, together with service providers and government, to identify and seek solutions to the specific problems they observe with their local health system. It also builds an enabling environment for citizen-led accountability and decision making.
Policy and Leadership
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National policies supportive of a population health management approach will aid decision making and service delivery, help enable local stakeholders to implement systems for community engagement, aid in the implementation of empanelment systems.
Continuity
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Continuinty of care is a complimentary strategy to creating and maintaining empanelment systems and bringing services to the community through proactive outreach.
Coordination
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Coordination of care is a complimentary strategy to creating and maintaining empanelment systems and appropriately reaching populations being served.
First Contact Accessibility
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First contact accessibility is compliementary to population health management initatives including empanelment and proactive outreach by ensuring that PHC is the entry point to the health system.
Management of Services
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Strong facility leadership is necessary to ensure that strategic action plans and community engagement translate to actionable and tangible changes at the facility level.
Organization of Services
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Care teams help to facilitate the delivery of high-quality services to patient panels. Additionally, effective proactive population outreach is supported by appropriately trained, reliable, and available community-based providers who are integrated into local care teams to ensure coordination and continuity of patient care.
Financial Protection
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Patient lists for empanelment can be generated by financial coverage schemes. Financial coverage can promote the provider or facility each patient is empaneled to as the first point of contact through gatekeeping or other mechanisms.
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
"Goal 2B: support countries to ensure immunisation services are well-managed, sustainable, harness innovation and meet the needs of caregivers"
"Goal 2C: Work with countries and communities to build resilient demand, and to identify and address gender related barriers to immunisation"
Goal 3A: Strengthen national and subnational political and social commitment to immunisation
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Maternal and Newborn Health Thematic Fund 2018-2022
Outcome 4: Quality sexual and reproductive health information and services are accessible to prevent and treat obstetric fistula and other obstetric morbidities.
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HIV and Universal Health Coverage - A guide for civil society
Result Area 1: Primary HIV prevention for key populations in locations with high incidence
"Result Area 4: ""Fully recognized, empowered, resourcesd, and integrated community-led HIV responses for a transformative and sustainable HIV response"""
