Walking the Talk

CHAPTER 4: MAKING IT HAPPEN

Today, countries are working to recover from COVID-19, rekindle economic growth, and get back on the path of progress to their most important development goals, including poverty eradication and UHC. Fit-for-purpose primary health care is a powerful resource for this work. As countries continue to walk the talk on PHC reform, their rewards will grow through reduced health care costs, more resilient health systems, stronger human capital, higher productivity—and above all, longer, healthier, more satisfying lives for people.

Notes 1. For each of the three reform axes, that reform’s impacts on each of the four PHC shifts is discussed in turn. While points of overlap exist among some of the 12 matrix cells, this structure has important advantages of clarity and usability. It allows readers interested in a specific reform axis (for example, financing) to easily follow out its implications for each of the PHC change outcomes. Meanwhile, readers primarily interested in policy and practice solutions supporting one particular outcome (for example, crisis resilience in PHC systems) can quickly find the subsections where the impacts of each main reform thrust on this outcome are discussed. 2. Centers for Medicare & Medicaid Services (CMS). “Shared Savings Program,” CMS, n.d. 3. National Cancer Institute (NCI). n.d. “NCI Dictionary of Cancer Terms: Patient Navigator,” n.d. 4. Institute for Healthcare Improvement (IHI). n.d. “SBAR Tool: SituationBackground-Assessment-Recommendation,” n.d. 5. Institute for Healthcare Improvement (IHI). n.d. “5 Whys: Finding the Root Cause,” n.d. 6. Alliance for Health Policy and Systems Research. n.d. 7. Great Barrier Reef and World Migratory Bird. 2020. “Transparency for Development Proposals,” no. January: 4–5. 8. World Bank. n.d. “The World Bank Group’s Response to the COVID-19 Pandemic.” 9. Physician Licensure, n.d. “Interstate Medical Licensure Compact.” 10. NCSBN, “Nurse Licensure Compact (CLC).” 11. Our Impact. n.d. “THEnet: The Training for Health Equity Network.” 12. Institute for Health Metrics and Evaluation, https://vizhub.healthdata.org/lbd /under5. See also Golding et al. 2017. 13. Southern Metropolis Daily Client. “Outpatient Drugs for Hypertension and Diabetes Are Included in Medical Insurance, and the Reimbursement Ratio Is at Least 50%, Benefiting 300 Million People,” n.d. 14. CMS Innovation Center, “Comprehensive Primary Care Plus,” n.d. 15. See, for instance, Lao PDR WSS Multisectoral Convergence Project for Nutrition and Health and Nutrition Service Access Project (HANSA) https://www.worldbank.org/en/news/loans-credits/2020/03/12/lao-pdr-health -and-nutrition-services-access-project.

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Walking the Talk

Published on Jul 25, 2022Medicine

World Bank Publications

"Almost half a century ago, policy leaders issued the Declaration of Alma Ata and embraced the promise of health for all through primary health care (PHC). That vision has inspired generations. Countries throughout the world—rich and poor—have struggled to build health systems anchored in strong PHC where they were needed most. The world has waited long enough for high-performing PHC to become more than an aspiration; it is now time to deliver. The COVID-19 (Coronavirus) pandemic has facilitated the reckoning for that shared failure—but it has also created a once-in-a-generation opportunity for transformational health system changes. The pandemic has shown policy makers and ordinary citizens why health systems matter and what happens when they fail. Bold reforms now can prepare health systems for future crises and bring goals such as universal health coverage within reach. PHC holds the key to these transformations. To fulfill that promise, however, the walk has to finally match the talk. Walking the Talk:

Walking the Talk

Articles inside

What will the World Bank do?

Recommendations for donors and the international health community

References

Recommendations for countries

human capital

Conclusions

Notes

Building skills for multisectoral action among PHC practitioners

Financing multisectoral engagement

From fragility to resilience

A partnership to support primary health care

From inequities to fairness and accountability

mechanisms and team-based care models

From fragmentation to people-centered integration

resource allocation

revenue?

From dysfunctional gatekeeping to quality, comprehensive care for all

Priority Reform 3: Fit-for-purpose financing for public-health-enabled primary care

Social and practical support for a resilient health workforce

From inequities to fairness and accountability

From fragility to resilience

practice

From fragmentation to people-centered integration

Priority Reform 2: The fit-for-purpose multiprofessional health workforce

From dysfunctional gatekeeping to quality, comprehensive care for all

From fragility to resilience

From inequities to fairness and accountability

4.1 Why team-based care?

From fragmentation to people-centered integration

sharing in primary health care

and priority reforms

3.8 What has to change: Sectoral silos inhibit collaboration

References

Foundations for change: Enabling multisectoral action in PHC

Shift 4: From fragility to resilience

3.4 What has to change: Discontinuous delivery

health care inequities

Shift 3: From inequities to fairness and accountability

Shift 2: From fragmentation to people-centered integration

Shift 1: From dysfunctional gatekeeping to quality comprehensive care for all

Implications for primary health care

by income group and geographic location, 1950–2100

Policy recommendations

1 Key recommendations for fit-for-purpose primary

quality gaps

1.1 Defining primary health care

What the World Bank and its partners will do