Physical Infrastructure

The physical availability and quality of public facilities. It means ensuring the right number and distribution of facilities, as well as the right mix of facility types, to meet population health needs. It also means ensuring all facilities are equipped with the amenities and resources they need to provide safe, quality care, such as clean water, sanitation and waste disposal/recycling; telecommunication connectivity; power supply; and transport systems that can connect patients to other care providers.

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Timeliness

The ability of the health system to provide primary care services to patients when they need them, with acceptable and reasonable wait times and at days and times that are convenient to them.

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Safety

The practice of following procedures and guidelines in the delivery of PHC services in order to avoid harm to the people for whom care is intended.

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Efficiency

Efficiency refers to the ability of a health system to attain its desired objective(s) with the available resources, while minimizing waste and maximizing capacities to deliver care to those who need it.

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Effectiveness

Effectiveness measures whether health care and services are driven by evidence, adhere to established standards, and achieve their intended result.

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People-Centeredness

People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases.

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First Contact Accessibility

The capacity of a primary care system to serve as the first point of contact, or a patient's entry point to the health system, for most of a person's health needs.

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Coordination

Coordination of care refers to the system's ability to oversee and manage patient care over time and across levels of care to ensure appropriate follow-up, minimize the risk of error, and prevent complications.

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Continuity

Continuity is the degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context.

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Comprehensiveness

The provision of holistic and appropriate care across promotive, preventive, curative, rehabilitative, chronic and palliative service needs.

Indicators
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Access to emergency transport for interfacility transfer
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Availability of communications
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Availability of power
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Availability of basic water, sanitation and hygiene (WASH) amenities
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Health facility density/distribution (including primary care)
Related Concepts

Delivering high-quality primary health care requires many elements of the health system working effectively together. This mapping explores how different concepts with the framework relate to one another.

Upstream elements are those that are required to develop or improve a particular concept. Absence or poor performance of an upstream element is expected to negatively impact the performance of the concept of focus.

Complementary elements are those where improvements or developments in this area will be mutually beneficial to the concept of focus but not required for improvement.

UPSTREAM CONCEPTS
COMPLEMENTARY CONCEPTS
UPSTREAM SUBDOMAINS
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Policy and Leadership
Physical Infrastructure
COMPLEMENTARY SUBDOMAINS
Funding & Allocation of Resources
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Changes to the funding and allocation of resources for PHC as a whole can impact Facility Infrastructure, however it is not necessary that this aspect of financing alone would impact this input.
Purchasing & Payment Systems
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Purchasing & Payment systems often impact the acquisition of and investment into necessary infrastructure, however it is not necessary that spending on PHC alone would impact this input.
Management of Services
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Given some facility funding is decentralized, its management can be complimentary to the purchasing and maintainence of facility infrastructure. Additionally, facility performance assessments help identify potential areas for infrastructure prioritization and improvement.
People-Centeredness
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Person-centered care begins, in large part, with facility design. The close attention to patient-centeredness in primary health care facilities means that their design is, or should be, quite different from other kinds of health care facilities by being more in tune with the needs of diverse populations.
Resilient Facilities and Services
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Assessing resilience in service preparedness can help identify areas of vulnerability and opportunities for further investment in the physical infrastructure of a facility.
Improvement Strategies

Each PHCPI Improvement Strategy is designed to help decision-makers begin to plan and enact reforms within their own context by providing additional resources and evidence on the topic, as well as practical recommendations for action.

The explainer graphic below presents a quick overview of the concept of Physical Infrastructure. View the full Improvement Strategy on Physical Infrastructure to learn more.

Physical Infrastructure explainer graphic
Potential Funding opportunities

Interested in understanding how this topic intersects with investment opportunities from major funding streams? The Global Frameworks Mapping provides a starting point to help identify and make connections between key PHC topics, relevant funding initiatives, and investment cases.

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UNICEF Health Strategy 2016-2030
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Strategy for quality health infrastructure in Africa 2021-2030
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Strategy 2030: Achieving a Prosperous, Inclusive, Resilient, and Sustainable Asia and the Pacific
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Operational Plan for Health, 2015–2020
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Global Delivery Programs
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2020-2022 Strategic Initiatives