Why is PHC important?

In countries with strong PHC systems, fewer children die before their fifth birthday and more people live longer, healthier lives.^1,2,3  Notably, the Exemplars in the Under-5 Mortality topic identified that health systems interventions (most of which are delivered through PHC) contributed 30 to 60 percent of the reduction in under-five mortality. ⁴

A strong, effective PHC system is a critical foundation for assessing and meeting people’s health needs across the spectrum of services, age ranges, and populations. For instance:

• Pregnant mothers can receive regular antenatal care, ensuring the continued health of themselves and their babies.
• Children can have a point of contact to monitor their growth and development, as well as a place to turn when they are sick.
• People of all ages are able to access treatment for mental health services close to their homes, without risking the stigma of seeing a specialist.⁵
• Women of reproductive age, including adolescents, can access reliable information and quality services for sexual and reproductive health (including family planning) safely and confidentially.
• HIV+ patients can turn to the PHC system for antiretroviral therapy and counseling.
• Adults can have a consistent, accessible way to get treatment and medications for chronic illnesses and noncommunicable diseases such as diabetes and cardiovascular disease.

PHC is more than simply ensuring that health services are available. There are four primary functions of PHC, commonly referred to as the “4Cs”⁶. Person-centeredness is often considered alongside these original functions:

• Comprehensive care ensures the availability of services that cater to a wide range of health needs, including health promotion, prevention, diagnosis and treatment services, and referrals as needed, throughout a patient’s life. Comprehensive care provides sufficient breadth and depth of service coverage for holistic, patient-centered care in the community.
• First contact of care offers patients easy access to services, encouraging them to seek care from a primary care provider first (as opposed to not seeking care or bypassing to see a specialist).
• Coordination of care provides stable links between health care visits and services (including those outside of the remit of the PHC system) so that patients receive appropriate care for all their health needs. This includes effective medical record systems, PHC team meetings, and other forms of coordination.
• Continuity of care fosters strong provider-patient relationships over time, which improves people’s willingness to seek care and to adhere to treatments. This structure also includes informational and managerial continuity.

Building on these functions, the PHC system can serve as a platform to integrate need-specific “vertical” programs such as those for family planning, malaria, tuberculosis, and HIV.⁷ In addition to achieving economies of scale (e.g., utilizing the same health information system, combining training for health workers across these programs, providing services from the same PHC facilities) by integrating vertical programs, the PHC system can ensure continuity of care when patients have needs across these programs. With a growing global focus on the broader “horizontal” PHC system, there’s an opportunity for the PHC system to integrate need-specific programs to deliver comprehensive care.