Indicator Selection Process

The PHC Vital Signs 

The 25 PHC Vital Signs indicators provide a snapshot of primary health care (PHC) performance. The tools on this site enable users to quickly assess a country’s performance and create custom comparisons.

The Vital Signs indicators were selected through a rigorous process. We first developed a new Conceptual Framework that describes important components of a strong PHC system. We then identified indicators that measure a country’s performance on each component. To be included, an indicator must have data collected by a reliable third party source that is comparable across countries. Download Our Methodology

The Vital Signs indicators fall into five categories, which together, provide an overview of PHC performance:

  • System - Is PHC prioritized in the country's health system?
  • Inputs - Does the PHC system offer sufficient facilities, health care professionals, and supplies?
  • Service Delivery - Are services accessible and effectively organized, managed, and coordinated to deliver high quality care?
  • Outputs - Does the PHC system provide the essential services you need throughout each phase of life?
  • Outcomes - Does the PHC system efficiently deliver better outcomes and greater equity?

The Vital Signs indicators do have limitations. As you explore the Vital Signs tool, you will find that many countries have "No Data" for an indicator. 

In fact, of the 135 low and middle-income countries in the world, only one country -- Uganda -- has data for all of the Vital Signs indicators."

We intentionally included some indicators that measure important components of PHC delivery systems -- such as government primary care spending  and diagnostic accuracy -- even though they have few country data points. We want to call attention to the need for more measurement in these areas.

All of the data for the indicators are obtained from third party sources and though these are some of the best sources for data on global health, the quality of the data can still be improved. If you know of other data sources we should consider or have thoughts about how to improve data quality, please contact us at

Some important components of a strong PHC system, as described in our Conceptual Framework, are not reflected in the Vital Signs because there are no globally comparable data available, or no well-accepted methodologies for collecting the data. PHCPI aspires to significantly increase the availability of data by working with countries to develop and implement new ways to measure PHC performance.

Diagnostic Indicators

The Vital Signs are intended as a starting point for a deeper process of diagnosis and systems improvement. Like vital signs in a clinical setting, they help system managers and other stakeholders assess the general health of the PHC system and make improvements. 

PHCPI has started to develop a menu of Diagnostic indicators to help countries understand underlying causes of system challenges. The Diagnostic indicators will further measure key areas of service delivery – “the black box” – and help explain why gaps in care exist for the Vital Signs. System managers will be able to collect and analyze the most relevant diagnostic indicators for their improvement efforts.

The PHCPI team is now working to test and validate new indicators and develop appropriate data-collection tools. We will work with countries to develop and refine the Diagnostic indicators through partnerships with the Joint Learning Network for Universal Health Coverage (JLN) and other global networks.


For more information on our indicators: