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.

Factors Affecting Quality of Health Service and Patient Satisfaction in Community Health Centers in North Lampung, Sumatera

“…Bitton et al, (2017) stated that quality of public health center service was afected by system, input, output, and outcome. Peprah and Atarah (2014) stated that quality of health service can be measured by patient satisfaction.…”

Low‐ and lower middle‐income countries advanced practice nurses: an integrative review

“…Low and LMICs are recognized as having poorer health outcomes for their population due, in part, to insufficient healthcare resources (Bitton et al 2017). International efforts have attempted to address this disparity for LICs and LMICs through healthcare workforce development initiatives (Bodenheimer & Bauer 2016;Bryant-Lukosius & Martin-Misener 2016;Campbell et al 2013;Moreira & Lafortune 2016;OECD 2016;United Nations 2017;WHO 2016a;WHO 2016b;WHO 2016c).…”

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

“…Given their potential to serve as first points of contact for continuous, coordinated, comprehensive and people-centered health services, high-performing primary care systems are a necessary element for the achievement of the sustainable development goals, the operationalization of calls for universal health coverage, and the management of global pandemics 1 3 . While considerable research is available on primary health care and its constitutive elements, it is not clear which approaches are most effective to ensure that primary care systems consistently deliver safe and quality services, that harmful services are not delivered, that primary care delivery systems acquire the capabilities required for continuous improvement, and that all of the above add up to improved population health and other socially valued outcomes.…”