Featured case studies

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Indonesia

Policy Experimentation and a Strong Legal and Regulatory Framework

Adjustment to population health needs India

Decentralized Approach to Improving Community-Engagement in Priority Setting

Medicines & Supplies Tanzania

To ensure quality and safety of medicines, Tanzanian health authorities built on existing infrastructure and undertook a long process of converting informal vendors into accredited drug dispensing outlets (ADDOs). By June 2014, this program had trained over 19,000 providers - each linked directly to local primary care facilities - in almost 6,100 shops. In December 2018, the United Republic of Tanzania became the first WHO-recognized country in Africa to achieve a well-functioning regulatory system for medical products.

Policy & leadership Peru

Policies that go beyond politics

Population Health Management Turkey

Prioritizing patient choice and access through geographic and voluntary empanelment

Policy & leadership Malawi

Evidence-Based Reproductive Health Policy Development for Young People

Adjustment to population health needs Tanzania

Integrating diverse community perspectives through participatory priority-setting

Multi-Sectoral Approach Ghana

Integrating community-engagement activities into health reform plans

Adjustment to population health needs Costa Rica

Supporting evidence-based priority setting through robust local data systems

Multi-Sectoral Approach Nepal

Building community trust and participation in priority setting through Mother groups

Policy & leadership Kenya

Embedding quality improvement at all levels of the health system

Population Health Management Brazil

Building a national community health worker programme

Primary Care Functions Liberia

Maintaining access to PHC services during the Ebola Crisis

Population Health Management Mexico

Community-based outreach for non-communicable disease care

Population Health Management Mali

Proactive case community management in urban settings

Service Quality Haiti

Improving the efficiency of health centers through time-driven activity-based costing

Management of Services Ethiopia

Strengthening hospital management capacity through educational programs

Information & Technology Brazil

Impact of the use of information communication technology on women’s health

Management of Services Afghanistan

Balanced scorecard performance system for performance benchmarking and strategic management

Management of Services Costa Rica

Incentivizing quality and adherence to best practices via performance management

Purchasing & Payment Systems Chile

Health goals as the basis for a pay-for-performance scheme

Organisation of services Brazil

Improving health outcomes and coverage through Family Health Teams

Service Quality Costa Rica

Improving health outcomes and efficiency of care through PHC teams

Health Workforce Malawi

Implementing an interprofessional nursing program to bolster the health workforce

Access Cambodia

Using voucher programs to improve financial access to PHC

Health Workforce Brazil

A multi-faceted workforce program to address geographic disparities in access to health services

Access Ghana

Addressing transportation barriers through emergency referrals

Service Quality South Korea

Extending facility operational hours to improve patient access and service delivery

Service Quality Tanzania

Using participatory planning to implement interventions related to disrespect and abuse

Service Quality Peru

Improving the quality of health services through community monitoring

Policy & leadership Malaysia

Focusing on Quality Management to achieve equitable access to services

Funding & Allocation of Resources Nigeria

Open Contracting in Primary Health Care

Adjustment to population health needs Brazil

Using participatory budgeting to amplify patient voices

Organisation of services Iran

Training community-based health workers to provide team-based care

Service Availability & Readiness Estonia

Retraining and incentivizing providers to deliver high-quality PHC

Service Availability & Readiness India

Training informal providers as a way to improve provider competence and availability

Management of Services Rwanda

Enhancing mentoring and supervision to improve quality of services

Service Availability & Readiness India

Using the Safe Childbirth Checklist to improve provider performance

Service Availability & Readiness Tanzania

Increasing provider competency through mobile-based decision-making tools

Medicines & Supplies Kenya

Assessing drug safety through increased inspections

Service Quality Rwanda

Strengthening safety systems with quality improvement practices in facilities

Management of Services Nepal

Morbidity and mortality conferences as a method for quality improvement

Primary Care Functions Malawi

Making care more comprehensive through an integrated care management model

Multi-Sectoral Approach Chile

Achieving comprehensive PHC through intersectoral action and community engagement

Primary Care Functions India

Improving provider’s capacity to coordinate care through the Continuum of Care Services mobile health tool

Primary Care Functions Portugal

Strengthening the delivery of integrated, continuous care across levels of care through the Portuguese National Network for Integrated Continuous Care

Access Afghanistan

During reconstruction in 2001, Afghanistan implemented a series of reforms to increase financial and geographic access to primary care services through partnerships with NGOs and the removal of user fees.

Organisation of services Solomon Islands

Strengthening coordination through role delineation policies

Primary Care Functions Costa Rica

Promoting coordination and first contact access through regional referral networks

Organisation of services China

Improving the management of NCDs through a tiered service delivery approach

Primary Care Functions Iran

Building demand for PHC via urban community health workers

Primary Care Functions Ethiopia

Delivering person-centred, integrated PHC via the urban health extension professional model

Service Quality Mali

Removing barriers to timely PHC through proactive community care management

Resilient Facilities & Services Liberia

Rebuilding PHC capacity in post-conflict settings through frontline health workers

Population Health Management Samoa

Revitalizing PHC at the community level through Village Women’s Committees

Primary Care Functions Scotland

Empowering patients through the Scotland House of Care Program

Funding & Allocation of Resources Kenya

Implementing a health coverage scheme to expand access to equitable, affordable, and quality PHC

Multi-Sectoral Approach Alaska, United States

Ensuring community involvement through co-ownership and co-management of the health care system

Purchasing & Payment Systems Estonia

Leveraging blended provider payment mechnisms to promote PHC

Purchasing & Payment Systems Indonesia

Capitation for primary care with some performance adjustments

Management of Services Costa Rica

Performance Measurement and Monitoring for Continuous Improvement

Ethiopia

Using regulatory mechanisms to improve the quality and resilience of services

Organisation of services Alaska, United States

Achieving effective voluntary empanelment

Primary Care Functions United States

Building a patient-centered model of care through multidisciplinary care teams

Purchasing & Payment Systems United States

Targeted Reforms to Reduce Costs and Improve the Quality of Care

Multi-Sectoral Approach India

Establishing community participation and decision-making power in local health systems

Service Availability & Readiness Costa Rica, Estonia, & Thailand

Improving provider motivation using monetary incentives

Service Availability & Readiness Burkina Faso, Ghana, India, Kenya, & Tanzania

Measuring provider motivation and satisfaction

Service Availability & Readiness Brazil, Cuba, Ghana, Kenya, & Nepal

Improving provider availability through facility infrastructure and workforce strengthening

Service Availability & Readiness Uganda & Rwanda

Addressing absenteeism through performance-based financing in Uganda and Rwanda

Service Availability & Readiness Ghana, New Zealand, & USA

Improving service delivery through shared medical appointment models

Primary Care Functions Kenya & Nepal

Using citizen charters as a facility-level intervention to increase accountability and empower patients

Service Quality Ghana & USA

Improving clinical efficiency through shared appointment systems

Service Quality Kenya, Nigeria, Rwanda, & Tanzania: Service Quality

Improving follow-up and reducing wait times through appointment systems

Access Iraq, Jordan, Syria, Ukraine, & Yemen

Delivering care to remote communities through mobile clinics

Access Project Echo & Ghana

Increasing geographic access to higher levels of care through eHealth/Telemedicine

Access Afghanistan & Lesotho

Expanding coverage of quality services through PPPs

Access India & Mexico

Conditional cash transfers to improve quality and utilization of care

Access Afghanistan, Burundi, & Kenya

User fees waivers for impoverished households

Access Laos & Rwanda

Community-based health insurance

Adjustment to population health needs Kenya, Nepal, & Malawi

Community Health Worker-Based Surveillance in Resource-Constrained Contexts

Adjustment to population health needs AFRO Region

Integrated Disease Surveillance and Response

Organisation of services Brazil, Costa Rica, & Ghana

Improving access to comprehensive care through geographic empanelment

Management of Services Kenya, Peru, Uganda, & Zimbabwe

Integrating communities into facility management decisions through leadership committees

Information & Technology Ghana, Mozambique, Rwanda, Tanzania, & Zambia

Health information strengthening initiatives

Service Quality Brazil & Costa Rica

Improving health equity through population outreach

Information & Technology Bangladesh

In 2009, Bangladesh introduced DHIS2 as the national health information management system to improve the integration and interoperability of different health information systems and to make the data produced by these systems more accessible and reliable to both data producers and users.

Purchasing & Payment Systems Argentina

Argentina’s Plan Nacer created new payment incentives for provincial governments and frontline providers, resulting in increased service utilization and improved health outcomes

Service Quality Alaska, United States

The Southcentral Foundation in Alaska, United States, has developed a system where patients are co-owners of the health system and are involved in all aspects of decision-making. 

Population Health Management Brazil

The Family Health Program was established in Brazil in the 1990s. Under this program, Family Health Teams are responsible for a geographically empaneled group of households.

Population Health Management Costa Rica

Costa Rica’s primary health care system is supported by robust care teams that provider community-based care to an empaneled population. As a result, health outcomes in Costa Rica are consistently strong and improving.

Organisation of services Costa Rica

Costa Rica's primary health care system is supported by robust care teams that provide community-based care to a clearly defined group of patients.

Primary Care Functions Costa Rica

Costa Rica’s primary health care system is supported by robust integrated care teams that provide comprehensive, coordinated, continuous, and person-centered care to empaneled populations. As a result, health outcomes in Costa Rica are consistently strong and improving. (Spanish subtitles)

Medicines & Supplies Dominican Republic

After creating a Single System for Managing Medicines and Medical Supplies (SUGEMI, in Spanish), the Dominican Republic has decreased the frequency of stock-outs and waste of unused, expired commodities and has decreased overall purchasing prices for drugs and supplies.

Management of Services Ethiopia

Ethiopia has implemented a series of reforms over the last several decades intended to improve service delivery and specifically improve care through stronger hospital management practices.

Population Health Management Ghana

The Community Health Planning and Strategy (CHPS) program began as a pilot in 1994 and has since been scaled across Ghana, increasing access to community-based primary health care services.

Information & Technology Ireland

Ireland launched its national eHealth Strategy in 2013 to transform its health information system and keep pace with the rapid global proliferation of technology using patient-centered, information-based eHealth solutions. Key eHealth initiatives at the core of Ireland’s reform seek to leverage the potential of innovative digital technologies to empower patients and healthcare workers by way of greater transparency, access to services, and information.

Population Health Management Jordan

Since 2019, the United Nations Refugee Works Agency has introduced various community-based programs to improve access to comprehensive primary health care (PHC) for the Palestinian refugee population in Jordan. These programs leverage digital technologies and proactive population outreach strategies to improve their implementation and spread in the refugee community as well as the quality, efficiency, and effectiveness of primary care services for these populations.

Access Mongolia

The Health Sector Development Program started in 1997 has supported various geographic and financial reforms that have worked to improve access to quality primary health care in both rural and urban areas.

Health Workforce Nepal

Since 2009, the Government of Nepal has been working in a public-private partnership (PPP) with the non-governmental organization Possible to expand access to high-quality health care in remote areas throughout the country. The partnership has developed a novel community health worker (CHW) program, to strengthen human resources for health and accelerate progress toward universal health coverage.

Service Quality Nigeria

The Nigeria Health Investment Program – which provided operating funds directly to frontline providers to spend as needed – has improved quality and coverage in three states in Nigeria. The approach is now being scaled nation-wide.

Resilient Facilities & Services Philippines

Rebuilding after Typhoon Haiyan/Yolanda towards a "new, better normal"

Physical Infrastructure Senegal

In Senegal, a proactive approach to gathering data through nationally representative assessments has helped the country determine priorities for implementing changes to facility infrastructure and amenities.

Physical Infrastructure Sri Lanka

In Sri Lanka, a focus on equitable access to health care has led to comparatively high provision of basic health services, but at the expense of consistent quality of care – leading patients to bypass community health services. Facility infrastructure assessments and investment are helping to bring users back into the primary health care system.

Access Thailand

Beginning in the 1970s, Thailand has implemented a series of reforms to improve financial and geographic access and achieve universal health coverage.

Health Workforce Vietnam

In 2013, the Ministry of Health of Vietnam launched the Health Professionals Education and Training for Health Systems Reform Project (HPET) for Health Systems Reform Project to execute a more sustainable and effective human resources for health development strategy. In particular, the project has made targeted efforts to improve the quality of workforce education and training to strengthen PHC capacity at the local level.

Funding & Allocation of Resources Uganda

Primary health care facilities in Uganda face challenges in having sufficient funds available to deliver a comprehensive set of PHC services. Analyzing the flow of primary care funds from national to facility-level helped to reveal some root causes of these challenges.

Adjustment to population health needs Multi-country

The Community of Practice Health Service Delivery: Strengthening Health District Teams to Accelerate PHC Improvement in Africa

Service Availability & Readiness Turkey

Greater availability of primary care services results in high patient and physician satisfaction.

Access Thailand

Improving geographic and financial access to care & strengthening primary care in Thailand

Access Namibia

Reducing health equity through commitment and innovation

Governance India

Decentralized governance and community engagement to strengthen primary care.

Organisation of services Estonia

Establishing family medicine as a specialty to strengthen primary health care.

Population Health Management Cuba

Emphasis on community-based primary care in a tiered system improves outcomes.

Access Costa Rica

Universal health coverage and community-based health teams create effective coverage.

Population Health Management Brazil

A Community-Based Approach to Comprehensive Primary Health Care.

Purchasing & Payment Systems

Measurement to Ensure Effective Universal Health Coverage: Plan Nacer/Programa SUMAR

Adjustment to population health needs Ghana

Translating Research into Practice to Ensure Community Engagement for Successful Primary Health Care Service Delivery: The Case of CHPS in Ghana

Adjustment to population health needs Chile

Measuring Primary Health Care System Performance Using a Shared Monitoring System in Chile

Primary Care Functions Multiple countries

8 Core Tenets of Primary Health Care Improvement in Middle and High-Income Countries

Policy & leadership

Strengthening Primary Health Care Systems to Increase Effective Coverage and Improve Outcomes in Ethiopia

Organisation of services Indonesia

Indonesia: Puskesmas and the Road to Equity and Access

Organisation of services Portugal

Strengthening the delivery of integrated, continuous care across levels of care through the Portuguese National Network for Integrated Continuous Care

Information & Technology Nepal

Strengthening PHC capacity in the public sector through an integrated health information system in Nepal

Access Oman

Ensuring universal access to PHC in Oman