Primary Health Care (PHC) approach and core health system capacities

This strategic objective is essential for all elements of the overarching goal of the GPW14 draft. It connects and enables activities across the domains of promotion, service delivery, and protection, and forms the foundation for resilience, health equity, and gender equality; it also serves as a cross-cutting enabler for other strategic objectives and outcomes, building and reinforcing community trust.

This objective reflects the reality that health and care systems must be fundamentally rethought and rebuilt—with sustainable health financing, a strong workforce, and assured-quality health products—to respond to the challenges of dynamic demographic changes (including population aging), epidemiological shifts, and converging crises.

This area of work recognizes the fundamental importance of strong, sustainable, and resilient health systems for health programmes, well-being, and health security. It also highlights the value of the primary health care (PHC) approach, which can deliver up to 90% of essential health and nutrition interventions and 75% of the anticipated health-related achievements of the Sustainable Development Goals.

Emphasis is placed on patient safety and service quality. The objective incorporates lessons from the COVID-19 pandemic, reaffirming that health systems must have sufficient capacity and resilience to prepare for and respond to emergencies.

Guided by the principles of health equity, gender equality, and the right to health, priority is given to removing barriers and providing services to underserved and vulnerable populations, including migrants, displaced communities, and persons with disabilities.

The approach promotes a shift from facility- and disease-based systems toward integrated, people-centered systems.

A three-pronged approach aims to:

• Enhance equity, efficiency, governance, and the impact of health systems;

• Address weaknesses in core system inputs;

• Harness the transformative power of digital technologies and data.

Joint Outcome 3.1: Rebuilding and strengthening the PHC approach to accelerate universal health coverage

Health systems will be continuously reoriented toward a primary health care–based approach, using context-sensitive methods aimed at integrating high-quality services that respond to people’s diverse health needs across the life course.

This work will address gender equality barriers and the right to health for all. The focus of this outcome is on strengthening core capacities and the approach used to scale up PHC in different contexts, ensuring that no one is left behind, while monitoring the impact of such initiatives.

Special attention will be given to strengthening public health functions and to planning, organizing, and managing high-quality health services—including nursing, surgery, and anesthesia—from primary to tertiary levels, through strategic planning for capital investments and upgrading sustainable health infrastructure, including hospitals.

Care models centered on PHC—operating across the life course, promoting patient safety, and delivered as close as possible to people’s daily environments—will be defined to ensure integrated delivery of comprehensive service packages, including health promotion and prevention (such as screening and vaccination), essential nutrition services, acute care and referral, self-care, evidence-based traditional and complementary medicine, rehabilitation and palliative care, and services that promote, protect, and improve the health of all populations, including Indigenous peoples, migrants, and refugees.

Digital systems enabling continuity of care and sustainable health records will be promoted.

Communities—guided by clear roadmaps for their engagement—will be at the center of this approach, particularly women, children and adolescents, persons with disabilities and chronic conditions, and vulnerable and marginalized groups. Efforts will focus on reaching the unreached, removing barriers to high-quality health services (including quality preventive, diagnostic, and treatment services), and ensuring their acceptance.

Health governance scope and capacities will be strengthened to promote transparency and combat corruption in health systems, which is a common barrier to equitable, high-quality care; enhance social participation; and advance the multisectoral approach required to:
address the health impacts of climate change;
tackle health determinants and risk factors;
advance antimicrobial resistance and the One Health approach;
engage communities and community-based organizations;
and regulate and manage the role of the private sector.