The World Health Report 2008: Primary health care, now more than ever

Why a renewal of Primary Health Care (PHC), and why now, more than ever? This report argues that moving towards health for all requires that health systems respond to the challenges of a changing world and growing expectations for better performance. This involves substantial reorientation and reform of the ways health systems operate in society today: those reforms constitute the agenda of the renewal of PHC. This report structures the PHC reforms that are needed into four groups:

  1. Universal coverage reforms: reforms that ensure that health systems contribute to health equity, social justice and the end of exclusion, primarily by moving towards universal access and social health protection.
  2. Service delivery reforms: reforms that reorganise health services as primary care, i.e. around people’s needs and expectations, so as to make them more socially relevant and more responsive to the changing world while producing better outcomes.
  3. Public policy reforms: reforms that secure healthier communities, by integrating public-health actions with primary care and by pursuing healthy public policies across sectors.
  4. Leadership reforms: reforms that replace disproportionate reliance on command and control on one hand, and laissez-faire disengagement of the state on the other, by the inclusive, participatory, negotiation-based leadership required by the complexity of contemporary health systems.

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