Primary Health Care Systems (PRIMASYS)

Far too many health systems around the globe fall short of providing accessible, quality, comprehensive, and integrated care. Realizing the 2030 Agenda for Sustainable Development requires integrated action on system-wide challenges, including on primary health care (PHC) systems in low- and middle-income countries (LMICs). A wide array of stakeholders including development agencies, global health funders, as well as policy planners and health systems decision-makers need a better understanding of primary health care schemes to plan and support complex health systems interventions.

Understanding the knowledge gap related to strategic information on PHC systems at national and sub-national levels in LMICs provides insights on the key points of entry to improve health programme implementation, effectiveness, and efficiency. To address these challenges, the Alliance for Health Policy and Systems Research is leading a portfolio of work entitled Primary Health Care Systems (PRIMASYS).

Research programme

PRIMASYS supports the development of twenty (20) case studies focused on primary health care systems in selected LMICs. Funded by the Bill & Melinda Gates Foundation, PRIMASYS aims to inform efforts to strengthen PHC systems and improve the implementation, effectiveness, and efficiency of PHC interventions worldwide.

The PRIMASYS case studies cover key aspects of primary health care systems, including policy development and implementation, financing, integration of primary health care into comprehensive health systems, scope, quality and coverage of care, governance and organization, and monitoring and evaluation of system performance.

The Alliance has developed both comprehensive and abridged versions of the 20 PRIMASYS case studies. The abridged versions provide an overview of the primary health care system, written for policy-makers and global health stakeholders interested in understanding the key entry points to strengthen primary health care systems. The comprehensive case studies provide an in-depth assessment of the system for researchers and stakeholders who wish to gain deeper insight into the determinants and performance of primary health care systems in selected low- and middle-income countries.

The case studies will serve as the basis for a multi-country analysis of primary health care systems, to understand the systems-level determinants of primary health care performance, and to draw cross-cutting lessons learned in the implementation of PHC policies and PHC systems reforms and interventions.

Expected outcomes

Knowledge generated from PRIMASYS will help to develop and implement PHC policies and programmes, inform national health plans and health systems reforms, and will serve as a potential guide for global health stakeholders, including development agencies, interested in strengthening primary health care systems in LMICs.

Case studies: Abridged versions available, full versions forthcoming














South Africa

Sri Lanka



United Republic of Tanzania