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Assessing Government Evidence for International PHC reforms

As a WHO Collaborating Center, our team is leading a project verifying governance arrangements towards strengthening health systems based on the primary health care (PHC) approach. Examining documents supplied by over 100 countries, we are assessing empirical evidence towards PHC reforms, as well as existing institutional arrangements such as policies, plans and stakeholder engagement. The project supports WHO’s ‘Assessing Health Systems for Universal Health Coverage’ project, a rapid review of policies, plans & practices globally. 

A two-story building surrounded by trees and tropical plants, with decorative silver streamers hanging across the entrance and signage displayed above the doorway.© Ranjithsiji, CC BY-SA 3.0, via Wikimedia CommonsA two-story building surrounded by trees and tropical plants, with decorative silver streamers hanging across the entrance and signage displayed above the doorway.

The Problem

The WHO launched the first global survey assessing health systems for universal health coverage, including primary health care (PHC), in 2025. Among the survey’s five modules, the WHO asked countries about their Governance arrangements towards PHC-oriented health systems. More than 100 countries provided documentary evidence to support such arrangements. Our team was tasked with reviewing these documents to verify these governance arrangements. 

Approach

Survey questions comprised standardized qualitative questions to fill gaps on core but historically undermeasured system-level aspects of PHC, building on key indicators of the WHO/UNICEF PHC measurement framework and recent WHO guidance and indicator lists on PHC, health system resilience and integrated models of care. Our team is using the documentary evidence base to verify whether PHC-oriented governance arrangements are in place, including recent reforms as well as institutional arrangements such as legislation, policies, plans and stakeholder engagement mechanisms. 

Impact

Findings will help assess country orientation and political commitment to PHC within the broader goal of accelerating progress towards Sustainable Development Goal 3.8 of Universal Health Coverage (UHC). Findings will be featured in the first-ever WHO global monitoring report on PHC and a peer-reviewed journal article.