Measuring primary health care performance: what’s new?


In their pursuing to meet global commitments, countries of the WHO European Region are renewing their commitment to primary health care (PHC) as a means of improving responsiveness and bringing cost-effective health services closer to individuals, their families and communities.

In order to increase transparency and public accountability, selecting appropriate dimensions for measuring PHC performance remains pivotal to creating systems that enable the development of conditions for improving health, while tackling the social determinants of health upstream. No consensus currently exists, however, on which PHC performance dimensions should be included, rendering assessments partial, context-dependent and unable to be used for comparison purposes.

A few ongoing initiatives have nevertheless sought to create platforms for discussion among experts and countries. Among them are the Expert Review Group set up by WHO headquarters in the context of the WHO Framework on integrated and people-centred health services, the Primary Health Care Performance Initiative, which arose from the alliance between the Bill & Melinda Gates Foundation, the World Bank Group and WHO, and the European Commission Expert Group on Health Systems Performance Assessment.

The Primary Health Care Expert Group of the Northern Dimension Partnership for Public Health and Social Well-being (NDPHS) has also started a reflection process on assessing PHC performance by sharing experiences of Baltic and Nordic countries, Poland and the Russian Federation.

To support this initiative and expand the reflection process to other countries, the WHO European Centre for Primary Health Care of the Division of Health Systems and Public Health organized a workshop on “PHC performance in the context of changing health needs” on 30 March 2017. Representatives from Kazakhstan, Kyrgyzstan, the Republic of Moldova and Ukraine joined NDPHS delegates at the event to discuss first-hand experiences of measuring PHC performance to inform policies at local, regional and national levels.

Participants concluded that dimensions such as person-centeredness, integration and quality need to be further developed in terms of analytical definitions and be captured in information systems. These dimensions are vital for strengthening people-centred health systems and supporting progress towards universal health coverage.