1.1.1 Countries enabled to provide high-quality, people-centred health services, based on primary health care strategies and comprehensive essential service packages

For health services to be truly universal and resilient, health systems must be redesigned around people, with high-quality and strong linkages between communities and health institutions. When health systems are people-centred, they are more effective, efficient, trusted. They foster stronger individual, family and community engagement and shared decision-making for their own health and promote better health literacy. To achieve this output, primary health care-oriented models of care are needed. They are operationalized with service packages for universal health coverage and implemented through integrated service delivery networks, with a continued emphasis on safety and quality of care. The introduction of innovations, such as digital health is also critical for improving health outcomes and reaching underserved populations to ensure that no one is left behind. 

The COVID-19 pandemic has shown the opportunities to invest in renewed and differentiated care pathways, which reduced the risk of COVID-19 transmission by delivering services closer to where people live and work, curbing unnecessary visits to health facilities while avoiding interruptions in treatment for chronic diseases and conditions. Health security and access to health services was maintained or improved through service prioritization and process redesign, decentralized infrastructures (such as laboratory networks), revised roles and functions (such as sharing skilled community health workers), and adoption of digital technologies, with a focus on improving patient flows and infection prevention and control. 

The COVID-19 pandemic also highlighted gaps in the ability of health systems to surge to meet increased demand, fundamental to achieving universal health coverage and maintaining essential services during emergencies. High-quality health services and capacity and deeply rooted programmes addressing infection prevention and control are necessary to prevent, detect and respond to health emergencies. 

Broader rebuilding of better health systems, focusing on the countries that are weakest, have been most affected by COVID-19 and continue to be facing major challenges, is required. The Secretariat will dramatically step up its country activities, with intensified support to those with least progress on universal health coverage, to strengthen service delivery through a primary health care approach, thereby improving preparedness and resilience of health systems to future shocks. 

The Secretariat support will foster coordination and integration across service delivery platforms and health programmes, including but not limited to vaccination; screenings; prevention, control and management of noncommunicable and communicable diseases; care and services that promote, maintain and improve maternal, newborn, child and adolescent health and ageing population; and mental health and sexual and reproductive health and rights. The Secretariat support will promote improved access across the continuum of care, from health promotion and prevention, to treatment, rehabilitation and palliation. 

Work to deliver this output also involves close collaboration on enabling a strengthened health workforce (output 1.1.5), effective governance (output 1.1.4) and the development of financing strategies (output 1.2.1); supporting access to essential health products and national supply chain management capacity (output 1.3.2); and enabling the strengthened capacity of health systems to monitor and assess progress (output 4.1.1). In addition, strong infection prevention and control (IPC) programmes at the national and health care facility level are a core capacity to keep health workers and persons using health facilities safe and to combat antimicrobial resistance (output 1.3.5). It also involves strong collaboration with regards to strengthening and monitoring essential health services and event-based case-management capacities and readiness and IPC measures for better health emergency preparedness and operational readiness (2.1.1, 2.1.2 and 2.1.3) and to provide essential services in fragile, conflict-affected and vulnerable contexts (output 2.3.3), enable the use of digital health technologies to support differentiated service delivery models and increase access to essential health services (output 4.1.3). Close collaboration will also be established for integrating equity, gender and human rights to ensure delivery of people-centred health services (output 4.2.6).