RT Journal Article
SR Electronic
T1 PHC Progression Model: a novel mixed-methods tool for measuring primary health care system capacity
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e001822
DO 10.1136/bmjgh-2019-001822
VO 4
IS 5
A1 Ratcliffe, Hannah L
A1 Schwarz, Dan
A1 Hirschhorn, Lisa R
A1 Cejas, Cintia
A1 Diallo, Abdoulaye
A1 Garcia-Elorrio, Ezequiel
A1 Fifield, Jocelyn
A1 Gashumba, Diane
A1 Hartshorn, Lucy
A1 Leydon, Nicholas
A1 Mohamed, Mohamed
A1 Nakamura, Yoriko
A1 Ndiaye, Youssoupha
A1 Novignon, Jacob
A1 Ofosu, Anthony
A1 Roder-DeWan, Sanam
A1 Rwiyereka, Angelique
A1 Secci, Federica
A1 Veillard, Jeremy H
A1 Bitton, Asaf
YR 2019
UL http://gh.bmj.com/content/4/5/e001822.abstract
AB High-performing primary health care (PHC) is essential for achieving universal health coverage. However, in many countries, PHC is weak and unable to deliver on its potential. Improvement is often limited by a lack of actionable data to inform policies and set priorities. To address this gap, the Primary Health Care Performance Initiative (PHCPI) was formed to strengthen measurement of PHC in low-income and middle-income countries in order to accelerate improvement. PHCPI’s Vital Signs Profile was designed to provide a comprehensive snapshot of the performance of a country’s PHC system, yet quantitative information about PHC systems’ capacity to deliver high-quality, effective care was limited by the scarcity of existing data sources and metrics. To systematically measure the capacity of PHC systems, PHCPI developed the PHC Progression Model, a rubric-based mixed-methods assessment tool. The PHC Progression Model is completed through a participatory process by in-country teams and subsequently reviewed by PHCPI to validate results and ensure consistency across countries. In 2018, PHCPI partnered with five countries to pilot the tool and found that it was feasible to implement with fidelity, produced valid results, and was highly acceptable and useful to stakeholders. Pilot results showed that both the participatory assessment process and resulting findings yielded novel and actionable insights into PHC strengths and weaknesses. Based on these positive early results, PHCPI will support expansion of the PHC Progression Model to additional countries to systematically and comprehensively measure PHC system capacity in order to identify and prioritise targeted improvement efforts.