Key facts

• More than 1.6 billion people worldwide were at risk of falling into or further into poverty due to direct health expenditures of 10% or more of their household budget in 2022.
• By intensifying primary health care interventions in low- and middle-income countries, 60 million lives could be saved and average life expectancy could increase by 3.7 years by 2030.
• It is estimated that 75% of the health progress projected under the Sustainable Development Goals could be achieved through primary healthcare.
• To achieve primary health care targets, an additional US$200 billion to US$328 billion per year is needed to provide more comprehensive health services.

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What does primary healthcare encompass?

Since 1978, the concept of primary health care has been reinterpreted and redefined many times over the years, which has led to confusion in both terminology and practice. A clear and simple definition has been formulated to facilitate the coordination of future efforts in this area at the global, national, and local levels and to guide their implementation:

“Primary health care is a society-wide approach to health that aims to ensure the highest possible level of health and well-being and its equitable distribution by prioritizing the needs of populations as early as possible throughout the care chain, from health promotion and disease prevention to treatment, rehabilitation, and palliative care, and by remaining as close as possible to people’s everyday environment.” (WHO and UNICEF, A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals)

Primary health care encompasses three interdependent and complementary components: providing comprehensive and integrated health services, with primary care, public health goods, and functions as the central elements; implementing policies and measures across multiple sectors to address broader and upstream determinants of health; and engaging individuals, families, and communities and empowering them to increase their social participation, self-care, and self-responsibility in health matters.

Primary health care is based on a commitment to social justice, equity, solidarity, and participation. It is founded on the following observation: the attainment of the highest attainable standard of health is a fundamental right of every human being, without distinction.

To achieve truly universal health coverage, we must shift from health systems designed around diseases and facilities to health systems designed for people, with people. Governments at all levels must emphasize the importance of acting beyond the health sector to engage in a whole-of-government approach to health, integrating a health dimension into all policies and placing a strong emphasis on equity and interventions that consider the full spectrum of life courses.

The primary health care approach encompasses broader determinants of health and emphasizes physical, mental, and social health and well-being, considered holistically and interdependently. The goal is to provide care to individuals as a whole, addressing their health needs throughout their lives, rather than simply treating specific illnesses. Primary health care ensures that people receive comprehensive, high-quality care, from health promotion and prevention to treatment, rehabilitation, and palliative care, as close as possible to their everyday environment.

Why is primary healthcare important?

Member States have committed to renewing and implementing primary health care, the cornerstone of a sustainable health system that enables the achievement of universal health coverage, health-related Sustainable Development Goals, and health security, of which it is the “programmatic driver.” This commitment has been codified and reaffirmed in the Astana Declaration and its accompanying World Health Assembly Resolution 72/2, in global monitoring reports on universal health coverage, and in high-level statements of the United Nations General Assembly on universal health coverage. Universal health coverage, health-related Sustainable Development Goals, and health security goals are ambitious, but achievable. Progress toward these goals must be accelerated urgently, and primary health care is the means to achieve this.

Primary healthcare represents the most inclusive, equitable, cost-effective, and efficient way to improve the physical and mental health of populations, as well as their social well-being. Evidence of the large-scale impact of investments in primary healthcare continues to accumulate worldwide, particularly during crises such as the COVID-19 pandemic.

Worldwide, investments in primary health care contribute to improving equity and access, the efficiency of healthcare, the accountability and transparency of health systems, and health outcomes. While some of these factors are directly linked to the health system and access to health services, it is clear that other, highly diverse factors play a vital role as determinants of health and well-being, including social protection, food systems, education levels, and environmental factors.

Primary healthcare is also essential for improving the resilience of health systems to crises, enabling them to more proactively detect early signs of epidemics and better prepare them to respond quickly to sudden surges in demand for services. While the data continues to evolve, it is already widely accepted that primary healthcare is the “gateway” to the health system and provides the foundation upon which to build essential public health functions to address public health crises such as the COVID-19 pandemic.

WHO action

The WHO helps countries reorient their health systems towards primary health care, which will be a key means of achieving universal health coverage and Sustainable Development Goal 3, and of achieving health security. Health systems must be adapted to people, context, and purpose. Strengthening health systems involves strengthening health governance and financing; health workers; gender mainstreaming, equity, and rights; information systems; quality of care and patient safety; maternal, newborn, child, and adolescent health and healthy aging; sexual and reproductive health; medicines and medical supplies; emergency preparedness, response, and recovery; and activities related to communicable and non-communicable diseases, among others.

The WHO has identified three strategic areas of work to strengthen primary health care globally:

1. Establish a “one-stop shop” to provide Member States with support for the implementation of primary health care, tailored to each country’s context and priorities. This includes applying the operational framework for primary health care and leveraging investment opportunities arising from the COVID-19 response to better rebuild primary health care-based health systems as part of recovery efforts. This core function builds on existing work and draws on experiences from several countries and regions worldwide.
2. To generate data and innovations focused on primary health care, with a greater emphasis on those left behind. These activities aim to find innovative solutions by building on existing data, recommended best practices and implementation solutions, the expertise of successful countries, and relevant publications. Key deliverables include guidance on monitoring and measurement to assess progress in primary health care implementation in countries and, subsequently, a global report on the progress of primary health care, as well as innovative capacity-building initiatives through the WHO Academy.
3. Promoting the renewal of primary health care through political leadership, advocacy, and strategic partnerships with governments, non-governmental organizations, civil society organizations, development partners, related UN agencies, donors, and other stakeholders at the global, regional, and national levels. Several initiatives will be undertaken under this workstream, including: establishing an external strategic advisory group on primary health care to advise WHO on the renewal of primary health care worldwide; creating an award to recognize excellence in primary health care globally; and encouraging the development of new partnerships and collaborative networks in this area that include emerging actors, such as young health leaders, parliamentarians, and civil society at large.