Intended for healthcare professionals


Practical tools for improving global primary care

BMJ 2015; 351 doi: (Published 13 October 2015) Cite this as: BMJ 2015;351:h5361
  1. Lara Fairall, associate professor1,
  2. Kieran Walsh, clinical director2
  1. 1Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa
  2. 2BMJ Learning and Quality, London, UK
  1. Correspondence to: L Fairall Lara.Fairall{at}

Universal health coverage can be achieved only by strengthening primary care, and new tools are needed

The sustainable development goals launched last month commit the world to achieving universal health coverage by 2030.1 Achievement will depend on providing high quality primary healthcare. Last month also saw the launch of a new partnership, the Primary Health Care Performance Initiative (, which aims to strengthen primary care in low and middle income countries through enhanced monitoring and sharing of best practices and tools. But the few practical tools that currently exist are often inadequate. We need better integrated, concise, and user friendly materials that can help health workers manage the wide range of problems seen in primary care.

For the past three decades, the World Health Organization has led the development of practical tools for primary care with the publication of charts, handbooks, and intervention guides for use by health workers with limited resources and training. The guidelines of the 1990s advised empirical treatments with essential medicines for clusters of symptoms and covered sexually transmitted infections2 and life threatening illnesses in young children.3 In the 2000s this approach was replicated for pregnancy and childbirth4 and respiratory conditions. …

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