Core components of Inputs

  • Improving the core components of inputs has many potential benefits, including:

    High-quality PHC

    Access to reliable, high-quality inputs is a prerequisite for high-quality PHC. However, to achieve desired outputs and outcomes, they must be coupled with well-planned and well-executed service delivery processes. This helps to ensure that inputs are transformed into higher primary care functions (coordination, comprehensiveness, etc.) and that service quality (effectiveness, efficiency, safety, etc.) is achieved. See the 5S-5M-5Cs framework below for a list of essential service delivery processes/mechanisms. 12

    Responsiveness to the community

    Facility design and distribution, a strong PHC workforce that promotes patient-provider trust, and availability of supplies and providers are all critical components when it comes to achieving person-centred care, which ultimately helps to build health systems responsive to the health status and needs of community members. Health systems and the environments in which they operate are constantly in flux, due to contextual changes such as population composition and political economies. At the same time, the fields of medicine and public health are dynamic, with new information, guidelines, and best practices emerging frequently. Strong inputs can strengthen a country’s ability to adapt to these external forces to ensure that the health system is evolving to effectively and equitably meet population health needs with high-quality care. For example, the presence of a skilled, motivated workforce and well-designed facilities can help to ensure the delivery of people-centred care. 245678


    In addition, the presence of reliable, high-quality inputs strengthens a country’s ability to identify and respond to public health problems. For example, countries can use the data generated from information systems to better prevent, prepare for, and respond to health emergencies. 78910

  • The following principles should also be prioritised, either at the same time or one after another, to support the transformation of inputs into desired PHC outputs and outcomes:

    Inputs are of high-quality

    Inputs are required for the delivery of care, but ensuring inputs are of high-quality is critical in a country’s strive for universal health care and high-quality PHC. Strong physical infrastructure, availability and effective regulation of medicines and supplies, an equitably distributed and highly-skilled workforce and efficient information and technology systems are all examples of the kinds of high-quality inputs a health system needs in order to be delivering the best possible care. Each of these inputs are extremely complex and must be contextualized within the setting in which you are trying to improve. For more information on how to improve the quality of health system inputs, explore each of these inputs individually in their respective modules (Physical Infrastructure, Medicines & Supplies, PHC workforce, and Information & Technology)

    Inputs are readily available

    Inputs must be available within a health system in order to deliver care. The absence of staff, supplies, health facilities and information systems will directly limit a country’s ability to deliver care. Regular monitoring of the availability of health care inputs as well as robust reporting systems are essential in improving the equitable delivery and coordination of inputs within a health care system. 11 Basing the distribution of health inputs on relative population risks as well as where in the population delivery of care is most needed is a critical part of improving equity. 11

    Inputs should be prioritized together

    The domain of inputs has four core components and they are each vital to the success of a country’s health system. It is important to recognize that the availability and presence of one works to support the presence and availability of another - they are mutually reinforcing. However, the ability to prioritize all four at the same time is not always feasible. The way resources are allocated and distributed within a health system will be based on priority-setting and the investment decisions made upstream by policymakers and government officials (i.e. priority setting exercises, policy decisions etc.) Often, there are not a lot of guidelines surrounding how to allocate inputs across varying geographic areas or how they should be prioritized within different contexts, leading to variation in the decisions being made at the local level.11 Consensus at the national level that all four health system inputs are vitally important and should be prioritized together as much as possible is critical.

PHCPI is a partnership dedicated to transforming the global state of primary health care, beginning with better measurement. While the content in this report represents the position of the partnership as a whole, it does not necessarily reflect the official policy or position of any individual partner organization.


  1. Bitton A, Veillard JH, Basu L, Ratcliffe HL, Schwarz D, Hirschhorn LR. The 5S-5M-5C schematic: transforming primary care inputs to outcomes in low-income and middle-income countries. BMJ Glob Health. 2018 Oct 2;3(Suppl 3):e001020.
  2. Veillard J, Cowling K, Bitton A, Ratcliffe H, Kimball M, Barkley S, et al. Better Measurement for Performance Improvement in Low- and Middle-Income Countries: The Primary Health Care Performance Initiative (PHCPI) Experience of Conceptual Framework Development and Indicator Selection. Milbank Q. 2017 Dec;95(4):836–83.
  3. WHO. Transforming Vision into Action: Operational Framework for Primary Health Care. WHO; 2020 Dec.
  4. Kruk ME, Ling EJ, Bitton A, Cammett M, Cavanaugh K, Chopra M, et al. Building resilient health systems: a proposal for a resilience index. BMJ. 2017 May 23;357:j2323.
  5. WHO. Primary health care: transforming vision into action - Operational Framework. Global Conference on Primary Health Care. 2018;
  6. Unable to find information for 6824475.
  7. WHO, GAVI, The Global Fund, JSI, MEASURE Evaluation, DHIS2, et al. Data quality assurance (DQA), modules 1, 2, and 3. WHO; 2021.
  8. Unable to find information for 5959663.
  9. WHO. Understanding global health through data collection [Internet]. World Health Organization. 2022 [cited 2022 Apr 26]. Available from:
  10. WHO/Europe. European health report 2018 - Chapter 4: Defining the vision for harmonized and interoperable information systems for health in Europe [Internet]. WHO/Europe. 2018 [cited 2022 Apr 26]. Available from:
  11. Kuwawenaruwa A, Borghi J, Remme M, Mtei G. An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania. Int J Equity Health. 2017 Jul 11;16(1):124.
  12. Wagle K. Outputs Vs Outcomes: 15 Differences  [Internet]. Public Health Notes. 2020 [cited 2022 May 8]. Available from:
  13. Hannaway C. The differences between outputs and outcomes  [Internet]. Health Manager. 2011 [cited 2022 May 8]. Available from: