Vital Signs Report

A commitment to improving primary health care

New Vital Signs Profiles provide country-by-country snapshot of primary health care, enabling leaders to identify problem areas and make improvements over time

On the sidelines of the Global Conference on Primary Health Care, countries from around the world joined the Primary Health Care Performance Initiative to launch the Vital Signs Profiles, which provide a snapshot of the strength of primary health care in low- and middle-income countries.

The Vital Signs Profiles offer a more complete picture of the state of primary health care in different countries than ever before, providing insights into where systems are strong and where they can be improved. The Vital Signs Profile helps answer several key questions on primary health care systems:

  • Financing: How much money does the country spend on primary health care?
  • Capacity: Does the country have policies that prioritize primary health care? Does the system have enough drugs, supplies and health care providers?
  • Performance: Are people able to get the care they need, without financial or geographic barriers standing in the way? Is the care people receive of high quality?
  • Equity: Does the system reach the most marginalized people in society?

PHCPI – a partnership between the Bill & Melinda Gates Foundation, World Bank Group, and World Health Organization, in collaboration with Ariadne Labs and Results for Development – developed the Vital Signs Profiles to help policymakers, donors, advocates and citizens better understand and ultimately improve primary health care. Governments and donors can use each Vital Signs Profile to identify priority areas for improvement, track and trend progress over time, and ultimately improve primary health care. Advocates and citizens can use the Vital Signs Profile to hold leaders accountable and call for specific financing or policy reforms.

“I’ve said it before, and I’ll say it again – primary health care is the most important step that countries can take toward achieving health for all,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “With the data and insights that the Vital Signs Profiles provide, countries can understand where their systems are weak and take concrete steps to improve them.”


Half the world’s population still lacks access to essential health services, the majority of which can be delivered through strong primary health care. Primary care is a person’s first and main point of contact with the health system and connects people with trusted health care providers who can meet most of their health needs throughout their lives.

Recognizing the importance of primary health care, policymakers, donors, advocates and partners from around the world are coming together this week for the Global Conference on Primary Health Care in Astana, Kazakhstan to sign a new declaration committing them to strengthen primary health care as the foundation of health for all.

“Strengthening the front lines of the health system to ensure universal health coverage is a great investment,” said Dr. Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group. “It promotes good health, saves lives and builds human capital – the foundation of inclusive economic growth and an accelerator for poverty reduction.”

Despite its importance, primary health care is often the weakest link in a country’s approach to improving the health of its people. Significant data gaps make it hard to see where primary health care is falling short, and the data that does exist is often of poor quality or difficult to understand and use. Only a handful of low- and middle-income countries have public data on primary care service delivery, including information on whether patients can see trained providers when they need to, or if they receive the correct diagnosis.

The Vital Signs Profiles are an important step to filling some of these data gaps for the first time but show the need for countries to continue collecting more and better data on primary health care– especially service delivery and the capacity of the system to deliver quality care.

“This exercise [of developing a Vital Signs Profile] helped to identify measurement gaps in the health care system,” said Dr. Noor Hisham bin Abdullah, Director General of the Ministry of Health of Malaysia. “These gaps are pertinent and relevant to the policymakers of the health system who will have to prioritize the areas of concern and propose strategies for remedial actions.”

“Lack of measurement has made the condition of primary health care invisible to the public and to leaders,” said Dr. Atul Gawande, Executive Director of Ariadne Labs. “It is essential to make the invisible visible. By not doing so, we are guaranteeing that this cornerstone of health will be deprived of smart investments and fail to ultimately reach those in need.”


By partnering with PHCPI to develop and launch Vital Signs Profiles, countries are making a public commitment to collect more and better data on primary health care and use it to improve the health of their citizens.

“I am so encouraged by the countries that are stepping forward and making bold commitments to improve primary health care,” said Ms. Gina Lagomarsino, President, and CEO of Results for Development. “With the data and insights that the Vital Signs Profiles provide, countries can take important steps to improve the health of their citizens.”

While primary health care looks different in each “Trailblazer” country, they all share a commitment to better measure and ultimately improve, primary health care for their people and communities. In 2019, PHCPI will continue working with these countries to gather and analyze additional data on primary health care systems, and look to engage new government partners to create Vital Signs Profiles for their countries.

“The process of developing the first set of Vital Signs Profiles has started important conversations in several countries about what it will take to achieve health for all,” said Beth Tritter, Executive Director of PHCPI. “PHCPI is excited to work with additional countries in the future to develop Vital Signs Profiles, and help connect different countries to share insights and innovations in data collection and use.”

“The exercise [of developing the Vital Signs Profile] was a great learning experience and inspired reflection on our programs, capacities, financing, evaluation systems, and improvement processes,” said Dr. Diane Gashumba, Minister of Health of Rwanda. “We are eager to engage even further on the primary health care improvement journey, eager to share best practices and learn from others and meet our national and international goals.”

Tareq Salahuddin

Dr. Tareq Salahuddin is an award-winning journalist and a Special Correspondent of News Hour. He is a Public Health Professional working in the development sector. Dr. Tareq, a medical graduate, is a member of Public Health Association of Bangladesh and a former member of the Governing Council and Policy Committee of the World Federation of Public Health Associations (WFPHA), a J2J Fellow on HIV/AIDS and a member of the International AIDS Society. To know more about Dr. Tareq, please visit his personal website ( or simply Google his name.
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