Fast track to strong primary health care

Centrum Medyczno-Diagnostyczne in Siedlce

Universal health coverage – the ideal that all people can access health services where and when they need them, without financial hardship – is a WHO priority.

Primary health care can meet more than 70% of people’s health needs throughout their lifetime, from health promotion and disease prevention to treatment and management of long-term health conditions. It is one of the smartest ways to deliver health for all.

By bringing health services closer to people’s homes and partnering with them to manage their health needs, primary health care also embodies people-centred care.

WHO has identified 10 areas for countries to focus on to improve the performance of their primary health-care systems, boost health outcomes and ensure equitable access to health services. This list draws upon the considerable volume of evidence and best-practice studies from across the WHO European Region.

10 accelerators for strengthening primary health care

  • Provide comprehensive services that deliver continued care from birth to old age
  • Create conditions for patients and their carers to manage chronic conditions
  • Establish multiprofile health-care teams
  • Invest in the competencies of general practitioners and nurses
  • Integrate public health and primary health care
  • Integrate primary health and social care
  • Establish learning loops to improve quality of primary care
  • Empower health managers to govern locally and across sectors
  • Upgrade facilities
  • Align accountability and incentives

Throughout 2019, WHO/Europe will share examples of actions taken by countries that have invested in these accelerators. To start, we present 2 cases.

Spain: establishing multiprofile primary-care teams

Multidisciplinary care makes the best use of the skills mix of the health workforce. Teams can include general practitioners, nurses, social workers, psychologists, nutritionists, health promoters, clinical pharmacists, physical activity counsellors, community health workers and front-desk staff.

These health workers interact closely with patients and families, draw up patient-specific treatment plans and share responsibility for decisions on patients’ health.

Since introducing these multidisciplinary care teams, Spain has seen a continuous improvement in the management of noncommunicable diseases, particularly diabetes mellitus and chronic obstructive pulmonary disease.

The country now plans to link these teams with social services and emergencies, further improving the delivery of people-centred care.

Poland: investing in the competencies of nurses

In Poland as elsewhere, primary health-care professionals, including nurses, are best placed to identify risk factors for noncommunicable diseases; guide patients through prevention initiatives and conduct preventive tests and screenings; educate patients on managing their health; and provide the care needed for a rapidly ageing population.

With this in view, over the last 13 years Poland has strengthened its commitment to primary health care and the nursing workforce by raising basic training to graduate and postgraduate levels, by introducing nurse-initiated prescribing of medicines, by setting up new roles for family nurses and palliative care nurses, and by establishing nurse-led practices.

These changes have helped to improve health outcomes and have also enlarged the role that primary care plays in taking care of patients in the community, as close to their homes as possible.