Primary Health Care Measurement and Improvement (PHCMI)

Primary health care in the Region

Since the Alma-Ata Declaration of 1978, all Members States in the Region have reaffirmed their commitment to PHC as a cornerstone of sustainable health systems for the achievement of universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs) through the Doha Declaration (2008), Salalah Declaration (2018), Astana Declaration (2018), United Nations General Assembly Political Declaration on UHC (2019), 72nd World Health Assembly resolution WHA72.2 on primary health care (2019).

The PHC approach is defined by 3 components:

integrated health services to include PHC and essential health functions

addressing the broader determinants of health through multisectoral policy and actions, and

empowering individuals, families and communities to take charge of their own health.

Although the situation in the Region has led to the adaptation of the family practice approach, which has proved effective in many cases, it was also observed as not necessarily the standard approach for all contexts. Overall, PHC has been disease-centred rather than people-centred in the Region. Therefore, it is important to shift the focus from disease to people and understand that PHC is not limited to health systems. There is a need for collaboratively shifting from the elements of Alma Ata to the 3 components of the Astana Declaration as PHC faces new challenges and health emergencies.

The COVID-19 pandemic has exposed structural, institutional, financial and resource availability inadequacies at the PHC level; there has been lack of clarity on the role of PHC in the COVID-19 response. Lack of systematic community engagement and empowerment and sustainable multisectoral actions and policies made it challenging for countries to mount an effective COVID-19 response, especially at the start of pandemic. The pandemic has re-emphasized that PHC is the first point of contact between individual and community health and national systems and constitutes a critical interface with health security. This has also called for a movement to make PHC “everybody’s business” and share an understanding of the role of PHC to progress towards UHC and health security in the Region.

Related areas of work