Today marks an essential step toward innovation in how we deliver health care – and it starts with the release of our report, “Integrating Community Insights to Build Responsive Primary Health Care Systems.” This report ends a six-month assessment, completed with ThinkPlace, examining the challenges and opportunities for integrating under-reached community insights into primary health care (PHC) systems in Africa. It also marks a beginning.
The Future is Responsive
The road began in Kigali, at the African Health Agenda International Conference (AHAIC) 2023. While there, we hosted an event that challenged participants to answer a question: “What could the future of African health care look like?”
The answer reached by this community of like-minded people was resounding: the future is responsive.
Responsive PHC systems ensure that health care services are available when and where they are needed, can adapt to changes in demand, are resilient to stresses and routinely factor in the needs and preferences of under-reached communities. By listening to and acting on feedback from communities we can ensure everyone has access to quality, affordable health care built to withstand shocks.
At this conference, VillageReach convened an event called “What does it take to build responsive Primary Health Care systems?”, which brought together a diverse group, including governments, implementers, activists, funders, and academics, to discuss how we can create health systems that are responsive to the needs of all people, especially those who are most marginalized and who have the worst health outcomes. After the event, we committed to continue this important investigation to build a healthier future for Africa together.
Following AHAIC, the road twisted and turned through Mozambique, the Democratic Republic of Congo, Malawi, Kenya and beyond where we engaged with158 participants from governments, private sector, technology and data firms, funding partners, researchers, innovators, gamification experts, Community Based Organizations (CBOs) and under-reached communities; and more internally-focused assessments within VillageReach. In these sessions, we engaged with participants to define under-reached communities, understand existing efforts to engage these communities at scale and opportunities to design novel approaches to shift PHC systems toward responsiveness.
These assessments provided valuable insights into the current state of health care in four countries, and the challenges and opportunities for making PHC more responsive to the needs of all people.
What We Found
There are many reasons why responsive PHC is essential. First, it can help to improve health outcomes for all people. People with access to quality, affordable health care are more likely to live longer, healthier lives. Second, responsive PHC can help to reduce health inequities. By focusing on the needs of the most marginalized, we can ensure that everyone has the opportunity to thrive. Third, responsive PHC can help to strengthen health systems. By investing in PHC, we can build systems that are more resilient to change and sustainable in the long term.
But there are challenges.
PHC is often underfunded, which makes it difficult to provide quality care, and can be disjointed. While feedback is often collected, it can be siloed, small scale and viewed as a one-off project. Getting feedback from under-reached communities is hard, and even when feedback is collected, it’s often not acted upon. This can be due to limited time, resources or incentive for health workers or policymakers to make necessary change. As a result, under-reached communities may feel like their voices aren’t being heard and their needs aren’t being met. Our strong partnerships will be key to formalizing and routinizing systems that deliver at scale.
There is hope! We can build more responsive PHC systems by investing in more robust, systematic feedback mechanisms at scale, providing adequate funding and support to community structures, and rebuilding trust between under-reached communities and the health system.
The Road Ahead
Since AHAIC 2023, we have worked to develop an actionable framework to build systems capable of routinely gathering and acting upon community insights at scale. We call this the Community Insights to Action Framework. Action – this is the key. This framework is cyclical, with each turn of the wheel turning the PHC system to ever greater responsiveness to ensure that the needs and preferences of under-reached communities are at the center of the design and delivery of health services.
The iterative feedback loop is at the heart of the Community Insights to Action Framework, involving the following steps:
- Co-define actionable PHC needs and preferences metrics: Work with under-reached communities to identify the data that is most important to them.
- Aggregate insights via diverse and routine channels: Collect data from various sources, including under-reached communities, health workers, and government agencies.
- Prioritize and incentivize action: Use data to identify the most pressing needs and priorities and develop plans to address them.
- Activate PHC systems improvements: Implement the plans and monitor their impact.
- Close the loop: Communicate the results of the interventions back to under-reached communities, so they know that their feedback matters.
We believe the Community Insights to Action Framework can be a valuable tool to achieve our vision of a future where everyone has the health care needed to thrive. So, we have started the journey, but now it’s up to us to navigate the inevitable pitfalls and obstacles ahead. How do we translate these findings from theory to action?
VillageReach will test innovations for integrating insights, pilot models of Community Insights to Action and mobilize coalitions to advocate for a shared responsive PHC agenda.
I invite you to read the report and encourage you to join us in this vital work. I believe that we can create health systems that are truly responsive to the needs of all people. We need to increase funding for PHC, bolster political will, gather better data and act upon what we have. By creating fruitful partnerships and encouraging local autonomy in decision making, we can take the bold action necessary to create integrated systems for routinely gathering and acting on insights from under-reached communities.
I am optimistic. Together, we can build a healthier future for Africa.