Primary health care (PHC) was quite successful in driving progress in various health-related areas in the era of the Millennium Development Goals (MDGs). The continued importance of PHC in the current era of Sustainable Development Goals (SDGs) cannot be overstated. As the foundation of effective and equitable health systems, PHC is essential for achieving universal health coverage (UHC) and health security. By prioritizing PHC, countries can build resilient and responsive health systems that can address the evolving health needs of populations. The COVID-19 pandemic also highlighted the essential role of PHC in pandemic preparedness and response. Primary care facilities and providers have been on the front lines of the pandemic, providing testing, treatment, and vaccination services, as well as crucial public health messaging and education. Through the implementation of public health functions, community engagement and a multisectoral approach, countries could respond to the pandemic.
Despite its importance, PHC in sub-Saharan Africa (SSA) faces numerous challenges that hinder its effectiveness and accessibility. Many countries in the region struggle with limited budgets for health care, resulting in inadequate staffing levels, poorly equipped facilities, and insufficient supplies of health products and services. In addition, PHC is often overshadowed by trendier topics and initiatives in global health discourse. Furthermore, countries in SSA face challenges like emerging health problems, fragmentation, instability, conflict, and increasingly, climate change.
Financing PHC in SSA countries in the face of limited international funding and domestic economic challenges (such as increased debt burdens and inflationary pressure), poses additional strain on essential sectors like health and education. This requires a comprehensive strategy that emphasizes the mobilization of domestic resources, explores novel financing methods, and cultivates partnerships with a range of stakeholders. Such a multifaceted approach is crucial for alleviating the strain on PHC, allowing for sustained progress despite challenging circumstances. Furthermore, health systems need robust strategies, including diagonal approaches and integrated delivery models, prioritizing PHC for holistic care. Engaging diverse stakeholders and ensuring capacity-building are crucial. And obviously, stable political environments and strengthened governance are essential for effective healthcare delivery.
Africa CDC and the African Union have a crucial role to play in supporting member states to strengthen PHC. By advocating for increased investment, facilitating infrastructure development, strengthening supply chain management, and promoting regional collaboration, they can help countries in the region build stronger and more resilient health systems that better meet the needs of their populations.
The role of the International Institute for Primary Health Care in Ethiopia (IPHC-E)
Ethiopia’s Health Extension Program (HEP), launched in 2003, has revolutionized healthcare accessibility and utilization in the country, positioning it as a model of success in SSA. Its impact has sparked interest from neighbouring countries, prompting the establishment of the International Institute for Primary Health Care (IPHC-E) by the Ethiopian Federal Ministry of Health in 2016. The Institute aims to contribute to the revitalization of the global movement of ‘Health for All’ through the PHC approach.
The Institute has emerged as a pivotal player in the promotion of PHC, not only in SSA but also globally. Through a variety of capacity-building initiatives, advocacy campaigns, and networking platforms, the institute has been instrumental in fostering collaboration and sharing best practices across borders. By facilitating cross-country knowledge sharing and supporting evidence generation through implementation research, IPHC-E has contributed to the development and implementation of innovative PHC approaches in Ethiopia and other African nations. The institute also hosts a PHC resource center, which serves as a repository of valuable information and resources. With over 1.5 million hits and global engagement, this resource center has become a cornerstone to enhance knowledge and skills in PHC.
One of the standout contributions of IPHC-E to the global PHC movement has been its organization of various capacity-building programs. These programs, including the Global PHC Course, Health Harmonization and Alignment course, and Leveraging PHC for COVID-19 course, have attracted participants from diverse backgrounds and countries, underscoring the institute’s global reach and impact. By addressing key health system strengthening areas listed by the World Health Organization (WHO), these courses equip participants with the knowledge and skills needed to address the complex challenges facing PHC.
IPHC-E has also leveraged technology to facilitate knowledge exchange among PHC stakeholders. Through a series of webinars and establishing a PHC community of practice, the institute has provided a platform for experts and practitioners to share insights, best practices, and innovative solutions. With thousands of participants attending these webinars over the past three years, IPHC-E has demonstrated its commitment to fostering collaboration and driving positive change in the field of PHC. The PHC community of practice had over 840 active users as of February 14, 2024, the majority of whom are from Africa.
Furthermore, IPHC-E’s efforts culminated in the successful organization of an international conference on PHC in Addis Ababa, Ethiopia, in September 2023. With participants attending both in-person and virtually from around the globe, the conference served as a forum for assessing progress and challenges in advancing the goals outlined in the Astana declaration. By facilitating meaningful discussions and networking opportunities, the conference underscored the global significance of IPHC-E’s initiatives and its ongoing commitment to promoting excellence in PHC.
In conclusion, IPHC-E has emerged as a driving force in promoting PHC across Africa and beyond. Through its multifaceted approach encompassing capacity-building, advocacy, knowledge exchange, and networking, IPHC-E continues to play a pivotal role in advancing the global PHC movement. As it looks to the future, IPHC-E remains committed to its mission of building capacities, fostering collaboration, and promoting community engagement and multi-sectoral action to drive sustainable improvements in PHC delivery and outcomes in Africa and beyond.
