Polio drops
© Bill & Melinda Gates Foundation/Prashant Pranjar

The Primary Health Care Performance Initiative

The Primary Health Care Performance Initiative (PHCPI) is a new partnership that brings together country policymakers, health system managers, practitioners, advocates and other development partners to catalyze improvements in primary health care (PHC) in low- and middle-income countries through better measurement and knowledge-sharing. PHCPI will help countries track key performance indicators for their PHC systems, identifying which parts of the system are working well and which ones aren’t. This will enhance accountability and provide decision-makers with essential information to drive improvements. To make data actionable, this partnership will also provide a platform for countries to share lessons and best practices.  

PHCPI was officially launched by the Bill & Melinda Gates Foundation, World Bank Group, and World Health Organization on the sidelines of the UN General Assembly in September 2015.

For more information about PHCPI, download the PHCPI brief, refer to the FAQs about PHCPI, and familiarize yourself with our definition of strong PHC. To learn how to navigate this website, reference the PHC Vital Signs User Guide.

Our Activities

PHCPI supports stronger PHC through four interconnected areas of work. Learn more about our approach and activities.

PHCPI four areas of work

1. Strengthen Performance Measurement:

PHCPI will use existing and emerging data to monitor and report on PHC performance, promote accountability, and guide country improvement efforts. The PHC Vital Signs Indicators on this website provide a snapshot of PHC performance. PHCPI will also work with countries to expand data availability and develop additional indicators that pinpoint underlying challenges. 

2. Generate and Share Knowledge: 

PHCPI will extract lessons from effective PHC delivery models and provide countries with guidance on how to improve their own systems. 

3. Promote Country-level Improvement:

PHCPI will support countries in making improvements by working with the Joint Learning Network for Universal Health Coverage (JLN) and other global partner networks to collaboratively develop practical tools for PHC system improvements. PHCPI will support countries in using these tools to take meaningful steps in strengthening their PHC systems.

4. Engage Partners to Build Momentum:

PHCPI will elevate PHC as a global priority by bringing together a network of committed country-level policymakers, advocates and other development partners.

Our Products

PHCPI is working with partners to develop a set of tools that can be used to improve PHC in countries around the world.

PHCPI Conceptual Framework

PHCPI's Conceptual Framework lays out the most important components of a strong PHC system, to guide what should be measured in order to make improvements. 


PHC Vital Signs Indicators

PHCPI's interactive Vital Signs tool provides a snapshot of countries' PHC performance, and allows users to make comparisons across countries and indicators.


Diagnostic Indicators

To complement the PHC Vital Signs indicators, PHCPI is developing a menu of diagnostic indicators that can help countries understand the underlying causes of poor PHC system performance. 

New Surveys and Indicators

PHCPI will develop new indicators and measurement tools on important aspects of PHC that are not currently tracked. Learn more about our measurement agenda.

Practical Tools for Data Collection and Reporting

PHCPI is collaborating with a broad network of partners to develop practical tools that provide guidance on how to make PHC improvements. 

Promising Practices in Primary Health Care

PHCPI will identify examples of strong PHC systems and extract relevant lessons for countries. An initial set of case studies on promising practices are available on Brazil, Costa Rica, Cuba, Estonia, Kerala, Namibia, Thailand, and Turkey. 

PHC Evidence

PHCPI has partnered with McMaster University to identify the best policy evidence to guide country decision-makers in implementing policies with the greatest potential to strengthen their PHC systems.

How We Work with Partners

India TB Clinic
© Bill & Melinda Gates Foundation/Ryan Lobo
PHCPI was founded by the Bill & Melinda Gates Foundation, the World Bank Group, and the World Health Organization, in partnership with Ariadne Labs and Results for Development. The initiative is evolving to a much broader partnership, including with:


PHCPI was developed in response to countries' desires to better understand their PHC systems. PHCPI will continue to work with country leaders, ministries of health, and in-country organizations. PHCPI will also work with global networks including the Joint Learning Network for Universal Health Coverage (JLN)—a network of 22 countries in Africa, Asia, and Latin America committed to ensuring that essential health services are available and affordable for everyone who needs them—and the World Health Organization's communities of practice for the Global Strategy on Integrated, People-Centered Health Services (IPCHS).

Development Partners:

PHCPI encourages development partners to increasingly focus their funding and activities on PHC improvement, utilize the data and tools offered through PHCPI, and engage in conversations about how to support countries that have prioritized PHC.

Civil Society Organizations:

PHCPI is building a coalition of civil society organizations committed to supporting the development of strong PHC systems and driving global and national attention to the issue. Our Advocacy Toolkit provides more information about our work with advocates and how to get involved.

For more information or to get involved, please contact info@PHCperformanceinitiative.org.