What We're Reading: March 4, 2019
- More health-related data is available than ever before, yet poor data quality, lack of coordination across collection initiatives and infrequent reporting are restricting its effective use. We need better tools to help governments effectively use data for decision-making and improve health systems.
- The Civil Society Engagement Mechanism (CSEM) lays out ten ways that the UN HLM on UHC can be transformative, including: 1) Discuss national roadmaps from governments which include specific, measureable steps to build UHC by 2030; 2) Hold governments to eliminating out-of-pocket payments; 3) Ask multilateral and bilateral donors to make specific commitments to support UHC; 4) Challenge civil society to drive support for UHC.
- Mali’s “astounding” community health worker program is a model for countries around the world. This week, the government announced that it will offer free primary health care to all pregnant women and children under five around the country – a major change from previous approaches requiring people to pay out-of-pocket for health services.
- This week, global health leaders from more than 35 countries committed to roll out new health technologies in national health systems to improve the health and wellbeing of their citizens. The newly signed Delhi Declaration outlines the importance of health technologies to achieve the health-related Sustainable Development Goals.
- Global Health 50/50 will be releasing its next report – Equality Works – on March 7. The report will provide a look into the gender-related policies of global health organizations.
- Spain is the world’s healthiest nation – due in large part to its strong primary health care system – according to Bloomberg’s new Global Health Index.
- A new BMJ study carried out in high-income countries found that comprehensive primary health care was better suited to empower communities and provide holistic care than selective primary health care.
- A new report finds that better transparency in global health supply chains will improve access to medicines in low-and-middle income countries, but the way forward is not easy: it requires major system overhauls and strong political commitments.
Week of February 25: What We're Reading
- Domestic spending for health is on the rise, but still isn’t high enough. A new report on global health expenditure shows that less than 40 percent of all spending on primary health care comes from governments.
- A study in the US found that people in communities with more primary health care physicians live longer: moving to a zip code with a higher density of primary care physicians was found to increase a person’s life expectancy by up to 51 days.
- The WHO announced that this year's World Health Day will focus on universal health coverage. Details for how to join the campaign are forthcoming.
- Measuring primary health care expenditure has been difficult in part because of the lack of a universal definition and methodology. A new study finally provides a path forward.
- The UK National Institute of Health Research has launched a health policy and systems online research community via Slack. Individuals can share thoughts and ideas that will help inform future funding and programs.
- Cross-border vaccination continues to be a priority for the Global Polio Eradication Initiative, as unchecked movement between Pakistan and Afghanistan is threatening efforts to eradicate polio. Building resilient health systems can help ensure no one falls through the cracks.
- “Gathering real-time data is likely essential for advancing the scientific community’s ability to predict outbreaks,” writes a group of scientists attempting to identify outbreaks before they become pandemics.
- Prioritizing women’s health over all other health goals can, paradoxically, threaten the wellbeing of people and societies. Malawi’s experience highlights why we need equitable health systems that meet everyone’s needs.
Advancing Primary Health Care: African leadership and accountability on the road to UHC
Please join us for an event on the sidelines of AHAIC to discuss the need for more and better data to hold leaders accountable and improve primary health care; raise awareness of the Vital Signs Profiles and the One by One Campaign and showcase experiences; and key takeaways from PHCPI Trailblazer countries.
Will 2019 Be the Year of Making Primary Health Care Happen?
Last fall, policymakers gathered in Astana, Kazakhstan to renew their commitment to primary health care (PHC). The gathering marked the 40th anniversary of the landmark Declaration of Alma-Ata, which enshrined health as a basic human right and paved the way for global recognition of PHC as a fundamental component of national health systems.
Health for all or health for some? The Financial Times interviews WHO Director-General Dr Tedros
The Global Conference on Primary Health Care: Celebrate the 40th Anniversary of the Alma Ata Declaration
In 1978, a pivotal conference was held in Almaty, Kazakhstan, bringing together health experts and world leaders to commit to health for all. The Declaration of Alma-Ata, endorsed at that conference, formed the foundation for the last 40 years of global primary health care efforts.
PHC Vital Signs Profiles: Use our new tool to see what primary health care looks like in select “Trailblazer” countries
The Vital Signs Profiles are a new measurement tool that policymakers, donors, advocates and citizens can use to better understand, and ultimately improve, primary health care around the world. They provide an innovative snapshot of primary health care systems in individual countries, shining a light on where systems are strong and where they are weak.
Five Country Insights on Using Data for Improvement in Primary Health Care
The 30 practitioners from 13 countries across Latin America, Africa and Asia who gathered in Hanoi, Vietnam this September convened in the pursuit of a shared goal: achieving universal health coverage for their country’s citizens through strengthening their primary health care systems.
Request for Proposals: Primary Health Care
Ariadne Labs is developing a Primary Health Care Measurement and Implementation Research Consortium. This Consortium will bring together researchers and policy makers from multiple disciplines representing academic institutions, government agencies, international organizations, and non-governmental organizations to accelerate progress in primary health care (PHC) research in low and middle-income countries (LMIC). We are issuing a request for proposals (RFP) to develop a report on the gaps in measurement and improvement and approaches to address these knowledge gaps in one of four areas critical to effective PHC in these settings.
Revitalizing Health for All: Case Studies of the Struggle for Comprehensive Primary Health Care
Revitalizing Health for All examines 13 cases of efforts to implement comprehensive primary health care reforms in communities around the globe, including in Australia, Brazil, Democratic Republic of Congo, South Africa, and Iran. The case studies originated from an international research-to-action initiative that brought researchers and research-users from national public health systems together to design, implement, and assess local projects.
Open Letter to the Delegates of the World Health Assembly on the Need for Stronger Measurement
As the 70th World Health Assembly (WHA) meeting comes to a close, it is important to recognize that dialogue among country actors and the global community is critical for collective progress. In this open letter to WHA delegates, members of the Joint Learning Network for Universal Health Coverage Primary Health Care Measurement for Improvement Collaborative share key insights on the need to better measure and strengthen primary health care systems.
What Can Low- and Middle- Income Countries Learn from U.S. Primary Care?
In November 2016, Qualis Health, a Seattle-based nonprofit population health organization, convened a symposium titled “Primary Care in the United States: Lessons Learned to Inform Global Efforts to Improve Primary Care” at the Bill & Melinda Gates Foundation headquarters. Sixteen experts from across the U.S. shared examples of healthcare delivery that illustrate high-functioning primary care, and described system innovations for improved care, better population health, and effective healthcare spending. Read—and watch—to see what lessons pockets of excellence in U.S. primary health care can inspire around the world.
Adapting What Works: A guide for program managers, from program managers
The latest guide from CHMI summarizes the learnings and active ingredients identified through the Primary Care Adaptation Partnership. Developed in collaboration with the participating programs, this guide builds off the knowledge they’ve accumulated over years of providing health care for the poor.
Key Steps Toward Use of Data for PHC Improvement: Outcomes of the PHCPI Collaborative 3rd Meeting
The JLN Primary Health Care Improvement Collaborative met in Kigali, Rwanda to outline strategies to address priority measurement areas and work towards the creation of a practical measurement toolkit.
Primary Health Care as a Foundation for Strengthening Health Systems in Low- and Middle-Income Countries
The PHCPI partnership recently published an article in the Journal of General Internal Medicine underscoring why primary health care is essential to building strong health systems. The article gives insights into the core quality functions of primary health care, and provides a framework for understanding primary health care system performance.
We should spend at least three-quarters of our time on domestic resource mobilisation if we are serious about Universal Health Coverage and primary health care
On this UHC Day, our colleagues at the Universal Health Coverage (UHC) Coalition call on global health leaders to commit to spending three-quarters of our time on domestic resource mobilization. If the world is serious about achieving UHC, we need to rebalance spending and put countries in the driver's seat.
Spread the Word on Universal Health Coverage Day: Digital Toolkit
On Monday, December 12, the world recognize Universal Health Coverage (UHC) Day. Share the videos and graphics below to spread the word about why primary health care is the fastest, cheapest, most efficient way to reach UHC.
Measuring Primary Health Care System Performance Using a Shared Monitoring System in Chile
Over the last 15 years, Chile has developed a national shared monitoring plan for tracking the performance of its primary health care system. The plan consists of two parsimonious indicator sets: the Health Goals, which provide an economic incentive for frontline providers to meet service delivery targets, and the Activity Indicators, which increase financial transparency and ensure that municipalities are accountable for the health of their population. The process of data collection, review, and feedback is standardized throughout the country, and annual meetings allow for targets to be updated according to local needs. Chile’s monitoring system is an excellent example of how diverse stakeholders can work together to establish a simple method for assessing the overall performance of a primary health care system to promote accountability, incentivize quality, and drive improvement.
Ghana translates research into practice to ensure community engagement for successful primary health care service delivery
Ghana created the Community-based Health Planning and Services (CHPS) initiative in 1994 to aim of reducing barriers to geographic access to primary health care. Read on to learn about the critical success factors of the program--community engagement and participation--and practical guidance for implementation.
Rethinking mental health services
Although it is estimated that mental health disorders account for 14% of the global burden of disease, there is a major treatment gap for people suffering from these issues in low and middle-income countries. A recent review available through the PHC Evidence portal provides evidence of the utility of non-specialist health workers and other professionals with health roles—including doctors, nurses, social workers, and teachers without specialized training—in closing the mental health treatment gap through better detection, treatment, and rehabilitation of mental illness. These findings have important implications for policymakers and researchers seeking to improve population health, increase effective coverage for mental health services, and improve the primary health care workforce.
Shared decision-making is key to ensuring person-centered care
When you seek care, is the process is passive or participatory? How are decisions about your treatment made? Does your provider consider your preferences surrounding your care? Shared decision-making is a key mechanism for moving toward person-centered primary health care delivery. In a recent review available through the PHC Evidence portal, Hauser and colleagues assess the effect of shared decision-making on critical health outcomes, indicating that shared decision-making can strengthen provider-patient relationships, increase patient satisfaction, and improve clinical outcomes. Yet, more research is needed to develop scalable implementation pathways to support the integration of shared decision-making tools into routine care delivery and to generate standardized metrics to better assess this important function. Read on to learn more.
China Health Study, with input from PHCPI partners, recommends strengthening primary health care to improve outcomes and value
As countries around the globe grapple with aging populations, a rising burden on non-communicable diseases, and the omnipresent risk of outbreaks, developing people-centered, integrated health systems with primary care at their core becomes ever more essential. An analysis of 22 successful reforms reveal eight characteristics of successful primary health care reforms that countries can adopt to address their specific strengths, needs, and challenges. These tenets comprise a valuable framework for understanding the characteristics of high-performing middle and high-income country primary health care systems.
Infographic: Primary Health Care is the pathway to Universal Health Coverage
Why is primary health care so critical to achieving Universal Health Coverage (UHC)? A new infographic from the Primary Health Care Strategy Group illustrates why primary healthcare is the practical pathway to achieving UHC.
The Community of Practice Health Service Delivery: Strengthening Health District Teams to Accelerate PHC Improvement in Africa
Since 2009 the Community of Practice Health Service Delivery under Harmonization for Health in Africa (HHA) has grown to more than 1,400 members from 78 countries. Over the past seven years, the community focused on building a network of district health management teams that values and prioritizes information sharing and learning through a horizontal learning environment. A recent test of fast learning cycles in Guinea and Benin revealed the role of the community in enabling peer-to-peer communication and information exhange among disparate groups. Read on for deeper insights from the Community of Practice Health Service Delivery into lessons learned on starting a scaling a successful global network.
PHCPI Data Insight: ANC Coverage and Continuity Highlight Complex Issues Affecting Primary Care Services
It is widely documented that antenatal care (ANC) provides women with information on health behaviors for pregnancy and childbirth, risks and warning signs, contacts and procedures in case of problems, and help planning for a safe delivery. However, ANC services are largely unavailable or underutilized in many low- and middle-income countries (LMICs). This comparative analysis highlights opportunities for countries to learn from the successes of their peers to promote more continuous care and increase equity in access to essential services.
PHCPI Data Insight: Ending Preventable Maternal and Child Deaths
Despite progress made in the last two decades, maternal and child mortality rates remain unacceptably high around the globe. Read on to learn more about the role of strong primary health care systems in ending preventable maternal and child deaths and how more and better data can help the global community to ensure healthier lives for all women and children, everywhere.
Critical shortages of personnel and data jeopardize primary health care systems
Primary health care is one of the most cost-effective ways to equitably reduce morbidity and mortality and improve population health, but the realization of these potential benefits is dependent on having adequate numbers of competent, motivated human resources to deliver primary health care services. Read on for more information on the central role of health workers in achieving the health-related Sustainable Development Goals and opportunities to strengthen the health workforce.
Primary Health Care: The Path to Universal Health Coverage
Ariana Childs Graham, Director of the Primary Healthcare Initiative at PAI, shares her thoughts on primary health care (PHC) as the foundation of all health systems and the role of the Primary Health Care Global Strategy Group (PHCGSG) in increasing recognition and support for PHC in the global development arena and advocating for PHC as a foundational pillar of universal health coverage.
PHCPI Data Insight: Drug availability an essential component of effective primary health care systems
How can strong supply chains strengthen primary health care systems? Read on for an exclusive PHCPI exploration of why essential drug availability is an essential component of effective primary care systems.
Closing the Primary Health Care Measurement Gap
Strengthening primary health care (PHC) is essential to achieve universal health coverage and the health-related Sustainable Development Goals, and PHC system strengthening requires good measurement. The PHC Measurement for Improvement Collaborative, launched in April 2016 in Accra, Ghana by the Joint Learning Network for Universal Health Coverage and the Primary Health Care Performance Initiative, will co-develop practical tools and approaches – drawing on collective country experiences—to support country policymakers, health system managers, and frontline providers to effectively use data for PHC improvement.
Join us at Women Deliver!
Please join us at Women Deliver 2016 for an event focused on meeting the needs of women and girls through primary health care, led by Suzanne Ehlers and featuring Honorable Awa Coll Seck, Dr. Atul Gawande, and Angel Chibuye Chewla . Read on for more details about location and speakers.
PHCPI Data Insight: Primary Health Care Spending
Why is it important for countries to track and understand primary health care spending? Read on as Federica Secci, Health Specialist at the World Bank Group, discusses how accurate primary health care spending data is critical to improving systems and meeting Universal Health Coverage goals.
Unlocking the door to healthcare for all Nigerians
Universal Health Coverage has been a priority in Nigeria since 2000, but it was really the National Health Policy of 2006 and the National Strategy Development Plan of 2010-2015 that elevated the need for UHC in Nigeria. Still, despite both these documents, not much progress towards UHC had been made until former President, Goodluck Jonathan, passed a declaration that called health a fundamental right and the responsibility of the government.
More than numbers: how better data is changing health systems
The Health Data Collaborative, launched by WHO and partner development agencies, countries, donors and academics, will strengthen countries' capacity to collect, analyse and use reliable health data, thereby reducing administrative burden. A list of 100 core health indicators has been produced, and 60 low income and lower-middle income countries, and their supporting donors, will be using common investment plans to strengthen their health information systems by 2024.
Zika Outbreak Signals the Urgent Need for Strong Primary Health Care Systems
On February 1st, the World Health Organization declared the spread of the Zika virus a public health emergency. The declaration was the WHO's highest level of warning--so dire, in fact, that it has only been declared three times in the organization's history. Susanne Ehlers, President and CEO of PAI, weighs in on the importance of robust and universal primary health care services in preventing, identifying, managing, and treating outbreaks of infectious disease.
New Year, New Primary Health Care Challenges
Countries around the globe have committed to implementing reforms to achieve universal health coverage. Now what? Read on for a snapshot of what the Primary Health Care Performance Initiative (PHCPI) has planned in 2016 to support the global movement toward UHC through better primary health care.
An Evolving Global Movement Toward UHC: From Financing to Primary Care-focused Delivery
Commemerating the recent second annual UHC day, read on to understand how the UHC movement evolved from a nascent movement to a global force over the course of a few short years and learn why high-quality PHC is one of the best bets for achieving UHC goals.
Uniting Behind Universal Health Coverage
At the Conference on Universal Health Coverage in the New Development Era, which took place in Tokyo, Japan on December 16, 2015, World Bank Group President Jim Yong Kim shared his insight on the global momentum around universal health coverage and highlighted new partnerships, including the Primary Health Care Performance Initiative, that can work to accelerate progress towards the achievement of universal health coverage goals. Read on for President Kim's full speech.
PHCPI Data Insight: Delivering Continuity in PHC
When you go to a health facility, are you able to see the same doctor or nurse as the last time you visited? If you see a specialist, do they use information from your primary care doctor to inform your diagnosis and treatment? Are you referred to a higher-level facility, if necessary, for follow-up care? For some of us, the answer is yes. But for too many of us, the answer is no. Read on to find out why continuity of care is a critically important, but poorly understood, role of PHC systems.
Quality: A Catalyst for PHC-Driven UHC
What is a young mother looking for when seeking health care for her child, her elderly father or herself? Quality primary health care. Quality can drive the necessary convergence of the current global dialogue on universal health coverage (UHC) and primary health care (PHC), as a sharp entry point to catalyzing change at the frontline of service delivery. In this blog, Dr. Shams Syed of the World Health Organization reflects on the need for action to support countries in utilizing PHC performance as a key driver in achieving universal health coverage.
Primary health care and the Sustainable Development Goals
When supported by strong public health policies and with aligned efforts across social, economic, and political domains, primary health care has a central role in achievement of sustainable development. Originally published in The Lancet, this commentary explores the integral role that strong primary health care systems will play in the achievement of the Sustainable Development Goals and Universal Health Coverage.
PHCPI Data Insight: Health Workforce
Imagine traveling an hour to reach a health facility, only to realize that no doctors are there. Or taking medication for a month, to later find out that you received the wrong diagnosis. Imagine being a doctor at a clinic so busy you see over 40 patients a day, and aren't able to give each one the full attention they need. Good health workers are the cornerstone to strong health systems. PHCPI investigates how we can better understand what makes health care providers most effective for the patients they serve.
Saving Mothers & Babies Advances in Africa
For the hundreds of thousands of women and newborns who die during pregnancy or delivery each year across Africa, the underlying cause of death is a fundamental lack of access to basic health care. In this op-ed originally published in AllAfrica, Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, highlights how primary health care and better data can help improve access to quality health care for women and their newborns.
Achieving Global Health Goals by Strengthening Primary Health Care
Last month, world leaders came together to adopt the Sustainable Development Goals (SDGs)--a new global development agenda that sets ambitious targets, such as eliminate poverty, achieve gender equality and end hunger globally. Following the launch of the SDGs, World Organization of Family Doctors (WONCA) President Michael Kidd weighs in on the potential of primary health care systems to support the achievement of the health-related SDG and deliver quality health care to populations worldwide. He also proposes new indicators that, if comprehensively measured, can show us the strength of primary health care in countries around the world and help us understand how to further improve our systems.
Dear primary health systems, it's time for your checkup
What makes primary health care work? How can systems better function as a whole? Atul Gawande and Chris Elias speak with Devex about the challenges primary health care leaders face around the world, and how PHCPI is digging deep to understand these difficult questions.
New tool helps countries identify misalignments between UHC and PHC strategies and goals
To address the challenge of weak primary health care systems in low- and middle-income countries, members of the Joint Learning Network for Universal Health Coverage (JLN) Primary Health Care technical initiative have co-developed a diagnostic UHC Primary Health Care Self-Assessment Tool, a multi-stakeholder survey to help countries assess whether their health financing approaches are well aligned with primary care initiatives, efforts, and programs. Read on to learn more about the tool and discover highlights from early pilots in Malaysia, Ghana, Indonesia, and India.
A Decade of Tracking Progress for Maternal, Newborn and Child Survival: The 2015 Report
Countdown to 2015 recently released its final 2015 Report, A Decade of Tracking Progress for Maternal, Newborn and Child Survival. The report summarizes results in each of the 75 Countdown countries, examines trends in maternal and child health, and turns a critical lens to the Sustainable Development Goals (SDG) framework and future accountability efforts. The report shows that although some health issues and some countries have achieved considerable progress, important gaps remain that must not be forgotten in the transition to the SDGs. When delivered properly, primary health care can meet many of the needs of women and children to accelerate progress toward the SDGs and close the gaps identified in the Countdown to 2015 report.
The far-reaching impact of strengthening primary health care
With the launch of the new Sustainable Development Goals, health and development experts around the world are reflecting on what it will take to accomplish them. As a global community, this is a unique opportunity to think carefully about what works and what doesn’t, and to use the new goals to redouble our efforts to support programmes, solutions, and systems that work. Suzanne Ehlers, President and CEO of Population Action International, and Rosemary Mburu, Executive Director of World AIDS Campaign International, weigh in on the value of high-performing primary health care systems and call on country decision-makers to enact policies and budgets that lead to measureable improvements in primary health care.
Partnership Aims to Bolster Local Health Care Providers
Read The New York Times coverage of the Primary Health Care Performance Initiative (PHCPI) launch at a UN General Assembly high-level side event led by Chancellor Angela Merkel of Germany, Prime Minister Erna Solberg of Norway, and President John Dramani Mahama of Ghana. Watch the live video of the PHCPI launch event here.
Press Release: New partnership to help countries close gaps in primary health care
On September 26, 2015 on the sidelines of the United Nations General Assembly, the Bill & Melinda Gates Foundation, the World Bank Group, and the World Health Organization launched a collaboration to strengthen primary health care and advance progress toward the Sustainable Development Goals.
Primary Care: The First Step Toward Stronger Health Systems
Since the 1990s, Ghana has taken siginificant steps to improve primary health care, including launching the Community-Based Health Planning and Services (CHPS) program and ensuring financial access through the National Health Insurance Scheme. President John Dramani Mahama of Ghana joins fellow heads of state in signing the global framework for sustainable development and urges increased attention to strengthening health systems and enhancing the ability to respond to global health threats.
A transformation in health debates
The global health agenda has often suffered from fragmentation, taking a siloed approach to particular diseases and interventions. During the Ebola crisis, we saw that underfunded, fragmented and understaffed health systems can be quickly overwhelmed, allowing an outbreak to escalate into an epidemic. Jasmine Whitbread, CEO of Save the Children International, shares insight into building strong health systems so that all can have access to high-quality health care.
It's time to better understand what makes primary health care work
Recent crises, including the Ebola epidemic in West Africa, have been wake-up calls: too many primary health care systems are under-resourced and fragmented, leaving countries unprepared to reach everyone with needed health services. Read more for a call to action from leadership of The Bill & Melinda Gates Foundation, the World Bank Group, and the World Health Organization on the need for better measurement to guide meaningful improvements in primary health care systems.
Primary Health Care – Time for action!
As one of the leading groups embracing the Alma Ata Declaration for Primary Health Care 40 years ago, nurses have been calling for strong primary health care for decades. Dr. Judith Shamian, President of the International Council of Nurses (ICN), shares her perspective on the impact of the Ebola outbreak and calls for action on the need to re-conceptualize primary health care systems with focus on the centrality of the healthcare workforce.
Improving primary health care in Nigeria: What’s needed now
There is a growing commitment by Nigerian policymakers to address gaps in the health care system, including a strong focus on primary health care – the frontline of health. However, poor health outcomes persist throughout the country. No one appreciates more than we do that building a high-performing health care system, accessible to all, in our country is a great challenge, yet we are optimistic that Nigeria is on the right path. Muhammed Lecky, the Executive Secretary of the Health Reform Foundation of Nigeria (HERFON) and Tunde Segun, Nigeria Country Director for Evidence for Action (E4A), reflect on Nigeria's progress and the need for the right data and tools for evidence-based decision-making.
The need for global primary care development indicators
Health systems founded on strong primary health care are essential to achieve the Sustainable Development Goals and universal health coverage. Authors on behalf of the World Organization of Family Doctors' (WONCA) executive committee discuss the need for global primary care development indicators to strengthen primary health care systems. They call on the UN and other stakeholders to commit to the measurement and development of high-quality and comprehensive primary care.
India needs to generate new health system models
India's success in saving children's lives so far means that it hasn't just met but surpassed the UN's ambitious Millennium Development Goal (MDG) on child mortality. As the global community approaches the adoption of the new Sustainable Development Goals (SDGs) in September 2015, Bill Gates, founder and co-chair of The Bill & Melinda Gates Foundation, reflects on India's achievements and the need to make sure that primary health care systems reach every single person with high-quality services.