Expert Insight

On PHCPI's Transition: Letter from the Executive Director

Dear friends in PHC, 

Yesterday, we shared an important announcement below from our Steering Committee regarding the future transition of the Primary Health Care Performance Initiative at the end of 2022. I encourage you to read their full statement and context here.

On behalf of the Secretariat, we are so proud of what has been accomplished at PHCPI since its inception, and thankful to all who have played a role along the way -- from our colleagues across our seven core partner organizations, to the Ministries that partnered with us on a Vital Signs Profile, to the 125+ Allies Improving PHC, to our Communities of Practice, to many, many more. We at the Secretariat are ready to support the Steering Committee in this transition as their respective organizations step forward with an intent to incorporate the lessons and products from PHCPI into their day-to-day organizational work, with a focus on increasing their support at national and sub-national levels.

What originally drew me to PHCPI was the opportunity to work with this group of esteemed global partners to advance better measurement of primary health care – to support the many providers, organizations and colleagues working on the frontlines of health care everywhere. I believe we’ve been successful in advancing the global understanding of what strong primary health care looks like, and how it can be effectively measured. PHCPI has worked with more than 30 countries to develop an actionable snapshot of strengths and weaknesses across all pillars of primary health care in their health system, and contributed to the first-ever globally-endorsed framework and set of indicators for primary health care – released by our colleagues at WHO and UNICEF earlier this year.

Along the way, through our shared partnership, our core partner organizations have become increasingly strong champions and adopters of a PHC approach in their own work, and today share a strong conviction that improving PHC is the critical foundation of strong health systems in every country. I have full confidence that all involved will continue to carry this mission forward.

There also remains much work to do. Countries and communities are rightly demanding greater support for strong health systems based in primary health care, and global partners are hearing this call.  Moving forward, we all must come together in the next phase to help ensure primary health care gets its due. While there is now a greater global understanding of how best to measure and analyze PHC performance, we now must fill the substantial enduring data gaps in measuring the kinds of things that are most important to PHC service delivery - particularly quality - and develop and implement plans to systematically collect this data and comprehensively report progress.  While we know out-of-pocket expenditures on PHC are too high, we still need more and better data on financing to understand where funds are going and which investments are paying the greatest returns, so that we can ensure greatest impact for people and communities that need it most.  

Intentional political leadership and advocacy on primary health care will also remain critical. Even though systemic health inequities are receiving greater attention in the wake of COVID-19 – along with longstanding gaps in the foundations of health systems everywhere – this does not mean that improvements in primary health care will be a given in the years ahead. The pandemic has certainly led to greater focus and investment on health security and pandemic preparedness, but it is not clear that this will lead to the types of fundamental health system reforms necessary to prepare for the next crisis and meet people’s everyday needs. An intentional focus on strong primary health care – including a robust, competent, and properly equipped workforce that can provide the full range of essential and routine health services that people trust and want to use – is the approach we need for all of our biggest health goals, from winning the fights against major diseases, to preparing for the next pandemic, and to achieving universal health coverage once and for all.

It is officially past time to set aside the myth that primary health care is too complex, too expensive or too ambitious to act on. It is measurable. It is achievable. It is affordable.  And it is necessary: strong primary health care is the single best path forward if we want to see global commitments to Health for All translate to meaningful change for people and communities around the world.

We look forward to finishing the year strong and ensuring all of our active partners are supported to sustain momentum into 2023 and beyond. We are thankful to all the core partners for their commitment and hard work towards our mission of measurement in PHC, and would like to thank all of you for your fellowship and support in this journey.  I hope you will each continue to offer your personal and organizational dedication and effort towards a vision of a better world through stronger PHC.  I know everyone at PHCPI certainly will.




Jeff Markuns, MD, EdM, FAAFP
Executive Director
Primary Health Care Performance Initiative (PHCPI) Secretariat

To learn more about the Primary Health Care Performance Initiative and hear reflections from our partners at this time of transition, check out the PHCPI Legacy Project video series