Publication: Primary Health Care in the World Bank from FY2010-FY2020: The Extent and Evolution of Primary Health Care Activities, Projects, and Measurement in the World Bank from FY 2020–FY 2020

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Villar Uribe, Manuela
Feil, Cameron
Vicencio, Jasmine
Primary health care (PHC) is an essential building block for achieving universal health coverage (UHC). The World Bank Group’s (WBG’s) health, nutrition, and population (HNP) practice is committed to improving global health and strengthening health systems. Notably, the WBG has pledged to help partner countries achieve UHC through stronger PHC systems. While the Independent Evaluation Group found that 80 percent of WB project financing is allocated to the first level of care, more specific details about the extent to which the WBG has committed to PHC over the past decade is not well known. This paper captures the extent and evolution of PHC investment, activities, and measurement across the HNP portfolio over the past decade. Using the PHC performance initiative’s (PHCPI’s) tools, this evaluation systematically identifies and maps the PHC-related loan commitments, approaches, activities, and measurement across HNP projects. The project appraisal documents of HNP projects approved between fiscal year (FY) 2010 to FY 2020 were assessed. The implementation completion reports of projects were reviewed to identify enabling and inhibiting characteristics of projects. The WBG has been responsive to global PHC-related initiatives as evidenced by the increased extent of overall PHC investment across the HNP portfolio. This paper found that the WB uses three different approaches to strengthening PHC within projects, finding that 74 percent of WB HNP projects include PHC. In total, 25 percent of HNP projects adopted a comprehensive PHC strengthening approach, 44 percent used a specific PHC approach, and 5 percent used a health system strengthening with PHC approach. The use of each approach related to specific types of PHC-strengthening activities. Economic and health system capacities were found to be determinants of PHC approach adoption. Lastly, gaps in the measurement of PHC system strengthening and governance, service delivery processes, access, and quality exist. The WBG has demonstrated that it is increasingly committed to strengthening PHC systems in partner countries. However, several key opportunities and areas of improvement have been identified to apply in projects in the decade ahead.
Villar Uribe, Manuela; Feil, Cameron; Vicencio, Jasmine. 2022. Primary Health Care in the World Bank from FY2010-FY2020 : The Extent and Evolution of Primary Health Care Activities, Projects, and Measurement in the World Bank from FY 2020–FY 2020. © World Bank, Washington, DC. License: CC BY 3.0 IGO.
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