Operational Framework For Primary Health Care

The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PHC approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets. This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV.

This Primer is about the 'how' of primary health care (PHC) and brings together best practices and knowledge that countries have generated through 'natural experiments' in strengthening PHC with the best available research evidence. Despite the progress made towards PHC globally, the concept is still often misunderstood, even within the public health community. The Primer offers a contemporary understanding of PHC and more conceptual clarity for strengthening PHC-oriented health systems. It does so by consolidating both scientific evidence and an extensive sample of practical experiences across countries for the needed evidence to address practical implementation issues. The Primer is organized in three parts. Part I explains the PHC approach, its history, core concepts and rationale, and draws out lessons for transformation. Part II addresses operational and strategic levers that make PHC work. It covers governance, financing and human resources for health, medicines, health technology, infrastructure and digital health, and their role in implementing change. Part III concludes with a cross-cutting view of the impacts of PHC on the health system, efficiency, quality of care, equity, access, financial protection and health systems resilience, including in the face of climate change.

Social determinants of health – broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources – have a powerful influence on health inequities. In 2021, the Seventy-fourth World Health Assembly adopted resolution WHA74.16 on addressing social determinants of health, which encouraged Member States to integrate social determinants of health into public policies and programmes and adopt multisectoral approaches. The resolution requested the Director-General to develop an “Operational framework ... for the measurement, assessment and addressing, from a cross-sectorial perspective, of the social determinants of health and health inequities”. This Operational framework for monitoring social determinants of health equity provides countries with critical guidance on monitoring the social determinants of health and actions addressing them, and using data for policy action across sectors to improve health equity. The publication is meant as a resource for national governments and their partners. It was drafted under the guidance of an expert group and with internal contributions across the three levels of WHO, as well as through formal consultation with Member States, and was endorsed at the Seventy-sixth World Health Assembly.