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What is “PHC” and why is everyone talking about it?

August 12, 2019 by PATH

MB-18228-2000pxcrop.jpg A patient, James Musenda (right), discusses nutrition with Rebecca Anne Saiko, a nurse trained in nutrition assessment, counseling, and support by the Thrive Project in Mopani Chamboli Clinic in Zambia. PATH/Gabe Bienczycki

At the Mopani Chamboli Clinic in Zambia, nurse Rebecca Saiko provides nutrition assessment, counseling, and support to a patient. Photo: PATH/Gabe Bienczycki.

A primer on primary health care—what it is, why our sector is talking about it, and how we can make it better.

What is PHC?

Let’s start from the beginning. PHC stands for primary health care—the most basic package of essential health services and products needed to prevent disease, promote health, and manage illness. Primary health care typically covers about 80 percent of a person’s health needs during their lifetime.

  • Primary care and primary health care are not the same thing—but they are related. Primary care is one aspect of PHC—managing illness—and occurs when a trained provider diagnoses or treats a patient. Primary care can take place anywhere but is usually offered in a clinic or hospital. Primary health care extends far beyond just managing illness to include disease prevention (e.g., immunization) and health promotion (e.g., education) as well.

Why is everyone talking about PHC?

Primary health care is getting a lot of attention in the health and development sector for three reasons:

  • PHC is the means by which we will achieve universal health coverage—one of the United Nation’s Sustainable Development Goals for 2030. Universal health coverage means all individuals and communities can receive the essential health services they need without suffering financial hardship.
  • The world just celebrated the 40th anniversary of Alma-Ata—a 1978 declaration by the World Health Organization and UNICEF identifying primary health care as the key to attaining health for all. The declaration gained some traction at the time, but implementation stalled for a variety of reasons. In 2018, governments and health organizations convened in Astana, Kazakhstan, to reaffirm Alma-Ata’s original principles and renew political commitment to placing PHC at the foundation of achieving universal health coverage.
  • Investments in disease treatment alone will never be enough—there is growing recognition that the world needs to invest in prevention and education and stronger health systems to sufficiently protect and promote health. In particular, the West Africa Ebola outbreak (2013–2016) was a major wake-up call to governments and health organizations the world over.

How can we reimagine PHC to make it better?

Let’s look at the three specific ways current PHC systems could be reimagined:

  • Most current PHC systems are designed to treat the sick, not to keep people healthy—governments need to allocate more financing to primary health care, and in particular toward health promotion and disease prevention. Instead of waiting to spend money on treating the sick—which is more expensive—resources can be more efficiently used by keeping people healthy.
  • Most current PHC systems treat all people the same—instead of using a one-size-fits-all approach, we need a people-centered approach to PHC. That means studying when, where, and how people need and want to use primary health care across their lifetimes. Then designing a system to efficiently and effectively meet those needs, like through team-based care models and increased self-care options. Research has shown a people-centered approach to PHC is more likely to improve health.
  • Few current PHC systems take advantage of data and digital technology—worldwide, very few primary health care systems are taking full advantage of the increased quantity and quality of data, information, and evidence to improve PHC. As governments continue to invest in harmonized digital tools and health information systems, they must also invest in the human resources needed to turn this information into better clinical and management decisions.

The time is now

To achieve health for all by 2030, PATH, our partners, our fellow nongovernmental organizations, governments, and communities the world over must work together to reimagine primary health care with people at the center.

Let’s get to work.