This informal CPD article ‘Strengthening Primary Health Care: A Foundation for Universal Health Coverage’ was provided by The International Academy of Public Health (IAPH), a multi-disciplinary academy dedicated to advancing the global public health workforce.
Primary health care (PHC) is not just the entry point into a health system — it is the backbone that ensures health services are accessible, fair, and responsive to people’s real needs. Established in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana, PHC is globally recognized as the most cost-effective way to achieve universal health coverage (UHC) and improve the well-being of populations (WHO, 2018).
Universal health coverage (UHC) means that all people can access the full range of quality health services they need, when and where they need them, without facing financial hardship. It spans essential services from health promotion and prevention to treatment, rehabilitation, and palliative care.
What Is Primary Health Care?
The World Health Organization (WHO) defines PHC as a “whole-of-society” approach that includes not only treating illness but also addressing the broader factors that shape health, such as clean water, sanitation, nutrition, education, and social protection (WHO, 2018). Effective PHC systems center on people’s needs, providing continuous, coordinated care throughout their lives and empowering individuals, families, and communities to take part in their own health decisions.
Why Does PHC Matter?
Strong PHC systems improve health outcomes, reduce inequities, and lower costs. According to WHO, scaling up PHC in low- and middle-income countries could save 60 million lives and increase average life expectancy by nearly four years by 2030 (WHO, 2023). Moreover, PHC strengthens resilience during crises like the COVID-19 pandemic, countries with robust PHC systems were better equipped to maintain essential services and respond effectively.
Importantly, PHC is not only about efficiency; it is also about fairness, helping reach rural populations, refugees, and other marginalized groups who often face the greatest health risks (WHO, 2023). PHC also plays a central role in achieving the Sustainable Development Goals (SDGs) particularly SDG3: Good Health and Well-being, with an estimated 75% of the projected health gains linked directly to PHC investments.
UNICEF provide countries with operational frameworks
Global Examples: Adapting PHC to Local Needs
In the Eastern Mediterranean Region, the Eastern Mediterranean Public Health Network (EMPHNET) has developed a roadmap to strengthen PHC through the Family Health Team (FHT) approach. This model brings together multidisciplinary teams — including doctors, nurses, dietitians, and social workers — to deliver coordinated, person-centered care that addresses chronic diseases, maternal and child health, mental health, and preventive services (EMPHNET, 2024).
In Rwanda, a different but equally effective model focuses on decentralizing services. By establishing over 1,100 community health posts by 2021, the Rwandan government has ensured that no person must walk more than 24 minutes to reach care (WHO, 2021). This strategy, combined with task-shifting to address a 45% shortage of healthcare workers in rural areas, has significantly improved access and equity for rural and underserved populations, showing that PHC systems can be tailored to different contexts and still achieve shared goals.
How Do We Strengthen PHC?
Strengthening PHC is not just about building more clinics or hiring more doctors. It requires:
- Developing clear policies and allocating resources.
- Building strong leadership and governance.
- Training health workers with the necessary skills.
- Engaging communities to ensure services meet their needs.
- Using data to monitor progress and improve quality.
One major challenge is the global shortage of 18 million health workers by 2030, disproportionately affecting rural and low-income regions (WHO, 2023). For instance, post-COVID reforms in India’s National Health Mission expanded community health worker roles to include telehealth support, demonstrating adaptability in crisis recovery.
Successful PHC reform depends on collaboration across government, civil society, and local leaders, ensuring that strategies fit the social, cultural, and economic realities of each country (EMPHNET, 2024).
Global Commitments and Tools
International organizations, including WHO and UNICEF, provide countries with operational frameworks and measurement tools to guide PHC reform and track progress (WHO, 2023). These tools help ensure that reforms are not only ambitious but also practical and measurable.
Conclusion
Strengthening primary health care is not just a health sector goal — it is a societal commitment to fairness, dignity, and well-being. Strong PHC systems build healthier, more resilient communities, protect against emergencies, and ensure that no one is left behind.
To achieve universal health coverage and advance global health goals, countries must continue investing in primary health care — because lasting, equitable health progress always begins with people-centered, community-based care.
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References:
- World Health Organization (WHO). (2023). Primary health care. Retrieved from https://www.who.int/health-topics/primary-health-care#tab=tab_1
- World Health Organization (WHO). (2021). Rwanda’s primary health care strategy improves access to essential and life-saving health services. Retrieved from https://www.who.int/news-room/feature-stories/detail/rwanda-s-primary-health-care-strategy-improves-access-to-essential-and-life-saving-health-services
- World Health Organization (WHO). (2018). Declaration of Astana. Retrieved from https://www.who.int/publications/i/item/WHO-HIS-SDS-2018.61
- Eastern Mediterranean Public Health Network (EMPHNET). (2024). Strengthening Primary Healthcare through the Family Health Team Approach: A Summary of EMPHNET’s Roadmap.
- Khader, Y., Al Nsour, M., Abu Khudair, S., Saad, R., Tarawneh, M. R., & Lami, F. (2023). Strengthening Primary Healthcare in Jordan for Achieving Universal Health Coverage: A Need for Family Health Team Approach. Healthcare (Basel), 11(22), 2993.
