Strategic entry point 3: Reach universal health coverage through integrating a social determinants approach into primary health care

Addressing the social determinants of health (SDH) and promoting health equity in primary health care is essential for achieving sustainable health improvements and reducing systemic inequities. Primary care providers, including but not limited to family physicians and nurses, are uniquely positioned to mitigate health inequities as they often engage directly with patients’ psychosocial and environmental contexts. While the traditional focus on biological disease models has overshadowed the importance of the SDHE, current efforts increasingly emphasize their integration into health care practices. Effective strategies include tailored screenings, multidisciplinary care, community-centered interventions and leveraging data to improve preventive services. By embedding equity-driven practices into primary care, health systems can address the root causes of inequities, create more inclusive care models, and ensure that interventions are responsive to the needs of populations in conditions of vulnerability.

Building on the world report recommendation 4.3, “Reach Universal health coverage through primary health care”, this strategic entry point focuses on integrating social determinants of health into Primary Health Care (PHC) systems to address health inequities and foster equitable health. It aims to transform primary health care systems from a biomedical-centred focus to an equity-driven approach, by incorporating an SDH perspective into key areas of daily practice across various levels of work, especially at the local level. It consists of a series of interconnected processes organized into four core areas:

This strategic entry point is interlinked with other strategies to address the social determinants of health and advance health equity, as outlined in the SIMASHE knowledge-sharing diagram.