Why measurement?

Many countries have identified primary health care as an urgent priority, but lack comprehensive data to pinpoint specific weaknesses, understand their causes, and strategically direct resources to address them.
PHCPI believes that better data on primary health care can help to:

  • Drive improvements. Policymakers and health system managers need quality data to gauge the strengths and weaknesses of their countries’ primary health care systems, learn from the experiences of other countries, and ultimately drive the reforms needed for their particular contexts. 
  • Make the case for greater investment. Better data on primary health care gives policymakers and donors the information they need to track the impact of their investments over time, helping to make the case for increased investment.
  • Support civil society and citizens to hold leaders accountable. Advocates and citizens can use data on primary health care to draw attention to problems, hold leaders accountable to their commitments, and call for the specific policy and financing reforms needed to achieve health for all.

Recognizing the many benefits of quality data, PHCPI seeks to catalyze a global shift in primary health care measurement and improvement by:

  • Measuring what matters. Historically, most data on primary health care has focused on tracking inputs into the system – details like the total number of health workers, medicines and supplies available. While this information is important, it isn’t enough for decision makers to evaluate how well the primary health care system works in practice.  That’s why a major focus of PHCPI’s work is supporting countries to collect more and better data on service delivery – the interactions between a patient and their provider that influence whether a person gets the quality care they need, when they need it.
  • Making data accessible. National data systems and donor reporting requirements generate an avalanche of health information in many countries around the world, yet these rarely give countries a complete picture of what is – and isn’t – working in primary health care. Lack of coordination between different data sources and tools is also a major challenge. To make data more accessible, PHCPI works to create tools that compile and present information in a way that is easy for policymakers, donors and advocates to understand. Where possible, we also provide data that is globally or regionally comparable – making it easier for decision makers to learn from the experiences of other countries and apply relevant insights.
  • Ensuring that better measurement translates into improvement. To ensure that better data translates into stronger primary health care systems, PHCPI brings together countries and practitioners to share learning experiences and develops case studies and strategies that countries can use to address critical gaps in primary health care systems.

(c) Andre Fanthome -- CHMI vaccination card

The Measurement Gap

Health system managers typically have data on inputs such as total number of health workers, medicines, and supplies available. They also measure outputs like the percent of children vaccinated and the percent of pregnant women who deliver in facilities. These are crucial to measure, but they are not sufficient.

What countries often lack is performance data about the important processes required to convert inputs to high-quality care delivery and coverage outputs critical to producing strong outcomes. There is little quality data on how often health workers are present and how accurately they diagnose and treat patients. There is even less information on the experience of patients who receive care.

We call service delivery -- the interactions between a patient and their provider that influence whether a person gets the quality care they need -- the “black box” of primary health care.  Simply put, service delivery is not well understood and has not received enough attention. Countries and development partners need more and better information on this aspect of the primary health care system to understand what is standing in the way of people getting the care they need and drive the needed improvements.

 

A New Way of Measuring Primary Health Care

PHCPI developed a Conceptual Framework that describes important components of a strong primary health care system. It is intended to guide what should be measured to inform and drive efforts to improve primary health care. The Framework is based on evidence about the key characteristics and determinants of strong primary health care systems, building on existing frameworks for health systems performance. The selection of our Core Indicators and the creation of the PHC Vital Signs Profiles was informed by this Framework.

Download our methodology for creating the Conceptual Framework and selecting the initial set of Core Indicators, and read more about how we updated the Core Indicators