Eight Tenets of Primary Health Care Improvement

8 Core Tenets of Primary Health Care Improvement in Middle and High-Income Countries

Around the globe, spurred by the WHO’s call to action, a new paradigm for improved health care delivery is gaining momentum. It is called integrated people-centered health services or IPCHS and the goal is to provide the right service to the right patient at the right time. The foundation of IPCHS is a successful, high-functioning primary health care system.

The Primary Health Care research team at Ariadne Labs developed an 8-tenet model that characterizes effective primary health care systems in middle and high-income countries. The 8 tenets grew from our work with the World Bank on the China Health Study, which lays out a pathway for health care reform across China. As part of the study, 19 case studies were commissioned to analyze 22 performance improvement initiatives to strengthen person-centered, integrated primary health care in 10 counties in China and in 12 other countries.

The case studies were designed to provide a comprehensive understanding of successful strategies that can be used for improving primary health care delivery across a range of settings and through a range of approaches. The eight tenets were derived from the case studies and offer a framework for understanding and putting into action the characteristics of a successful primary health care system and are described below:

Tenet One: Primary health care is the first point of contact
Tenet Two: Functioning multidisciplinary teams
Tenet Three: Vertical integration, including new roles for hospitals
Tenet Four: Horizontal integration
Tenet Five: Advanced information and communication technology (eHealth)
Tenet Six: Integrated clinical pathways and functional dual referral systems
Tenet Seven: Measurement standards and feedback
Tenet Eight: Certification