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Status, and pathways to implementing the revitalised PHC approach in the WHO African Region: a mixed-methods study
Humphrey Cyprian Karamagi1, Sokona Sy1, Joseph Mung'atu2
1World Health Organization Regional Office for Africa, Brazzaville, Congo.
BMJ Public Health
|August 15, 2026
Summary
Implementing revitalised primary healthcare (PHC) requires integrating its drivers for better health outcomes. This study identifies optimal pathways for PHC implementation across the WHO African Region, focusing on country-specific priorities.
Area of Science:
- Global Health
- Health Systems Strengthening
- Primary Healthcare Policy
Background:
- The revitalised primary healthcare (PHC) approach aims to improve health outcomes but faces implementation challenges due to varied interpretations of its drivers.
- Understanding and appropriately applying PHC drivers are crucial for effective health system strengthening.
Purpose of the Study:
- To explore the current status of PHC drivers within the WHO African Region.
- To determine the most effective ways to apply PHC drivers for optimal implementation.
- To propose country-specific priorities and pathways for revitalised PHC.
Main Methods:
- Developed a measure assessing 17 PHC drivers (3 components, 4 strategic, 10 operational levers) across WHO African Region countries.
- Utilised stakeholder perspectives to derive specific indices for each driver.
- Applied structural equation modeling to analyse the optimal pathway for PHC drivers impacting health results.
Main Results:
- Country scores for PHC implementation ranged from 0.37 to 0.90 on a 0-1 scale.
- PHC driver scores varied, with PHC components averaging 0.71 and operational levers at 0.60.
- The optimal pathway involves PHC components influencing strategic levers, which then guide health investments via operational levers or system functionality.
Conclusions:
- Effective PHC implementation necessitates moving beyond policy statements to practically integrate and sequence its drivers.
- Targeted application of PHC drivers within the results chain is key for maximizing health impact.
- This study provides a framework for optimising PHC implementation strategies in the African Region.
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