DAY 1 SUMMARY & NEXT STEPS PHC IMPROVEMENT GLOBAL STAKEHOLDER MEETING

CONTEXT  PHC development for the future, not of the past Rebranding? Evidence, technology, knowledge of high-performing systems, multidisciplinary care, community empowerment and engagement  Needs to be squarely positioned within UHC, IPCHS Effective coverage and quality Access, multi-morbidity, changing disease burdens  Measurement activities should be linked to SDGs  Numerous partners engaged in improvement activities (financing/technical assistance/knowledge management/research/etc.) often context specific  Data needs and decisions different at each level (community, subnational, national, global)  Solutions are political (global and country level) as well as technical

CONTEXT (CONT.)  Health Data Collaborative offers a platform from which partner measurement activities can be integrated, harmonized and efficient around national health sector strategies  PHCPI could offer an organizing framework for measurement and improvement of PHC  Additional collaboration on these two efforts are encouraged

COMMUNITY/FACILITY MEASUREMENT  Data collection burden, but data not utilized  Data not actionable, not linked to local needs  PHC information systems less developed/not integrated  Financing data gaps IMPROVEMENT  Efforts often context specific  Role of community/civil society  Building a culture of and capacity for data use and continuous quality improvement  How to link measurement to improvement

SUB-NATIONAL MEASUREMENT  More data available for decision making  Need to optimize existing data collection platforms  Feedback, not just reporting IMPROVEMENT  Opportunities and challenges of decentralization  Organization and management  Empowerment/resourcing  Collaborative decision-making (multi-level stakeholders in country)  Knowledge management  HR capacities

NATIONAL MEASUREMENT  Sufficient data for decision-making  Actions not always aligned to data-driven and evidence-based decisions IMPROVEMENT  Competing priorities (national vs. donor, political vs. health system; intersectoral; limited resource pool)  Value of PHC reforms – effectiveness, efficiency, access  Financing and governance levers – how can they be better applied?  How can PHC improvement efforts align with IHP+/UHC Alliance?  Role of intranational and international comparison for benchmarking and identifying best practices

NEXT STEPS… ROADMAP

CO-DEVELOP A ROADMAP  Build from V.0 – the background document  Everything is up for discussion  We want your input and collaboration  What we develop today will shape roadmap

MEASUREMENT  Tension between: large data collection burden, and lack of use of available data BUT Recognition of data gaps for improvement in service delivery (particularly for cross-cutting issues outside of HIV, Malaria, TB)  Measurement of “black box” should be a country-led decision How can this be best supported by multiple stakeholders present?  How can quality concepts be better defined, then imbedded in existing platforms?  Opportunity to provide input through quality of care working group of Health Data Collaborative (led by PHCPI/GFATM) Today you’ll be tasked with developing draft ToR for measurement

POTENTIAL ACTIVITIES – TOR  Development of sub-nationally relevant indicators Prioritize areas for development within measurement gaps  Composite indicators  How to incorporate measures into existing measurement platforms?  Further refinement of PHCPI developed tools: frameworks, vital signs, diagnostics  Research consortium  PHC Self assessment guides for sub-national level  Global Report - PHC Performance

IMPROVEMENT  Technical and political opportunities at each level  Current activities disparate and context specific  How can the activities of partners present be more coordinated around: data use analysis for information knowledge generation, management and sharing guidance of best practices to guide action from knowledge Imbedding evidence supported strategies through national/sub-national systems  Though context specific, what service delivery concepts may be more universal?

POTENTIAL ACTIVITIES – SUPPORTING COUNTRY-LED IMPROVEMENT  How can stakeholders present align/collaborate for maximal support? Maximize knowledge generation/sharing Gain efficiencies Derive common improvement strategies (contextual vs. global)  Guidance on required elements of PHC for the 21 st century  Global knowledge management activities  Assessment tools linked to best practices  Implementation pathways  Partnerships (north-south/south-south)  Communities of practice  Potential role of a Global Challenge for PHC Could this help address some of the issues with low political economy?