Evidence

Amid massive health system disruption induced by COVID -19 pandemic, the need to maintain and improve essential health services is greater than ever. This situation underscores the importance of the primary health care (PHC) revitalization agenda articulated in the 2018 Astana Declaration. In this context, the objective of this study was to synthesize what was already known about strengthening PHC in low- and middle- income countries prior to COVID-19.  This study highlights that successful PHC strengthening initiatives require substantial reform across four strategic levers – political commitment and leadership, governance and policy, funding and allocation of resources, and engagement of communities and other stakeholders. Importantly, strategic reforms must be accompanied by operational reforms; the strongest evidence of improvements in access, coverage and quality related to service delivery models that promote integrated services, workforce strengthening and use of digital technologies. Despite major health system adaptations during the pandemic, change is unlikely to be lasting if underlying factors that foster health system robustness are not addressed. This is a useful study for implementers. Click here to read the study.