Strategic purchasing and provider payment systems enable countries to pool public funds and transfer these resources to PHC providers to deliver health services. Specifically, strategic purchasing means actively allocating funds according to providers' performance and the needs of the populations they serve. This can help countries incentivize greater quality and equity within the system, a stronger focus on primary care as the first contact, more efficient use of resources, and better integration of individuals' health care and public health.
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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.
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.
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.
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.
People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases.
People-centeredness means organizing the health system around the comprehensive needs of people rather than individual diseases. This involves engaging with people, families, and communities as equal partners in promoting and maintaining their health - including through communication, trust, and respect for preferences, as well as ongoing education and support so that they can participate in health care decisions.
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.
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.
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.
The system's ability to oversee and manage patient care throughout the course of treatment and across various sites of care to ensure appropriate follow-up, minimize the risk of error, and prevent complications. Coordination of care happens across levels of care and over time, and often requires proactive outreach on the part of health care teams and consistent tracking and communication of progress.
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.
The degree to which a patient experiences a series of discrete healthcare events as coherent and consistent with their medical needs and personal context. This requires fostering trusted relationships between health care providers and patients over time (relational continuity), ensuring information is communicated from one event to the next (informational continuity), and ensuring the process is managed in a timely, complementary, and effective way across providers (management continuity).
The provision of holistic and appropriate care across promotive, preventive, curative, rehabilitative, chronic and palliative service needs.
The provision of holistic and appropriate care across a broad spectrum of health needs, ages, and solutions. Comprehensive primary health care is able to address a majority of promotive, preventive, curative, rehabilitative, chronic and palliative service needs.
HBP defines a set of services to be financed from public sources that have been assessed for inclusion in the benefit package as part of a systematic, transparent process, including criteria on economic evidence and budget impact/cost effectiveness
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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Adjustment to Population Health Needs
Participatory and data-driven priority setting should determine how to prioritize purchasing and payment systems to support PHC.
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Policy and Leadership
PHC policies and leadership establish financing and expenditure plans and processes. PHC policies should include costed service packages and holistic strategies, including accounting for social determinants of health.
Purchasing & Payment Systems
COMPLEMENTARY SUBDOMAINS
Funding & Allocation of Resources
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The funding and allocation of resources for PHC can be related to the structures for Purchasing & Payment Systems, however the direction of influence is circumstantial and often complimentary.
Multi-Sectoral Approach
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Social accountability mechanisms can support monitoring of PHC spending and hold stakeholders accountable to commitments made.
Population Health Management
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Participatory and evidenced-based local priority setting should help to inform how to structure purchasing and payment systems to appropriately allocate limited resources to PHC at the sub-national level.
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.
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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Walking the Talk: Reimagining Primary Health Care After COVID-19
Outcome 2: Ensure reproductive health commodities reach the last mile and promote harmonization and integration of supply systems in countries
Outcome 3: Countries increase and diversify financial and programmatic contributions and prioritize reproductive health and family planning as a core element of sustainable development
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Strategy for quality health infrastructure in Africa 2021-2030
Goal 1B: Support countries to introduce and scale up coverage of vaccines for prevention of endemic and epidemic diseases
Goal 1C: Enhance outbreak response through availability and strategic allocation of vaccine stockpiles
Goal 2A: Help countries extend immunisation services to regularly reach under-immunised and zero-dose children to build a stronger primary health care platform
Goal 3B: Promote domestic public resources for immunisation and primary health care to improve allocative efficiency
Goal 3C: Prepare and engage self-financing countries to maintain or increase performance
"Goal 4A: Ensure sustainable, healthy market dynamic for vaccines and immunisation-related products at affordable prices"
Goal 4B: Incentivise innovation for the development of suitable vaccines
Goal 4C: Scale up innovative immunisation-related products
"Result Area 9: ""Systems for health and social protection schemes that supporrt wellness, livelihood, and enabling environments for people living with, at risk of, or affected by HIV to reduce inequalities and allow them to live and thrive"""
