Primary health care-oriented health systems are required to effectively tackle WHO’s current priorities including: WHO’s Thirteenth General Programme of Work, 2019–2023, with its triple focus on promoting health, keeping the world safe and serving the vulnerable; the global action plan for healthy lives and well-being for all, including the primary health care “accelerator” to enhance collaboration between partners in order to accelerate progress at the country level on the health-related targets of the Sustainable Development Goals; WHO’s framework on integrated people-centred health services; and WHO’s framework for action for strengthening health systems to improve health outcomes, with its six building blocks, in which the principles and strategies for action are aligned with the overall approach of primary health care and the “levers” outlined in the Operational Framework for Primary Health Care.

The Operational Framework for Primary Health Care provides more in-depth information for each lever and proposes actions and interventions to guide countries’ efforts to strengthen Primary Health Care (PHC)-oriented health systems. It draws extensively on the published literature, existing guidance documents, and, in some areas, agreements that have already been made by WHO’s Member States in the context of the World Health Assembly.

The Operational Framework for Primary Health Care is based on three essential components:

1. Integrated health services with an emphasis on primary care and public health functions: meeting people’s health needs through comprehensive promotive, protective, preventive, curative, rehabilitative and palliative care throughout the life course, strategically prioritizing key health care services aimed at individuals and families through primary care and the population, with essential public health functions as the central elements of integrated health services;
2. Multisectoral policy and action: systematically addressing the broader determinants of health (including social, economic and environmental factors, as well as individual characteristics and behaviour) through evidence-informed policies and actions across all sectors;
3. Empowered people and communities: empowering individuals, families and communities to optimize their health, as advocates of policies that promote and protect health and well-being, as co-developers of health and social services, and as self-carers and caregivers.

These levers expand on the health system building blocks to identify key elements of the health system that can be used to accelerate progress on PHC. The levers are interdependent, inter-related, and mutually reinforcing. The levers are separated into core strategic and operational levels. Core strategic levers can pave the way for actions around other levers; any sustainable improvement in the operational levers is unlikely without a strong grounding in the strategic levers. Actions and interventions for each lever are thus not intended to be carried out independently, and they should be mutually and comprehensively considered throughout national health planning processes.

Documents referenced:

1. WHO’s Thirteenth General Programme of Work, 2019–2023.
2. Global action plan for healthy lives and well-being for all, including the primary health care “accelerator.”
3. WHO’s framework on integrated people-centred health services.
4. WHO’s framework for action for strengthening health systems to improve health outcomes.
5. Operational Framework for Primary Healh Care