When we talk about universal health coverage, one thing is clear: it’s not enough for health systems to exist; they must be able to respond. Responsive Primary Health Care (Responsive PHC) is about ensuring that services are available when and where people need them, adapting to changing demands and reflecting the needs and preferences of communities.
This vision came alive as VillageReach marked its 25th Anniversary with partners in Kenya and Malawi. Across both gatherings, government leaders, health innovators, funders and community representatives shared reflections on how Africa can make Responsive PHC not just a goal, but a lived reality.
Putting Communities at the Center
At its heart, responsiveness begins with communities. People know where systems fail them, whether through long distances to facilities, frequent stockouts or lack of trusted providers. However, by listening to and designing with communities, health care becomes relevant, dignified and sustainable. As Dr. Ahmed Ogwell, President & CEO of VillageReach, reminded us: “We are not celebrating numbers. We are celebrating people: children vaccinated on time, mothers receiving safe care and health workers with the tools to serve.”
But listening alone is not enough.
From Innovation to Lasting Transformation
For Responsive PHC to thrive, innovations must move beyond pilots and become rooted in government systems. From digital tools to new supply chain models, transformation only lasts when solutions are adopted, owned and sustained by ministries of health. As Dr. Loice Rono, Advisor at the Office of the President, Kenya, put it: “Design solutions inside government systems, not around them, so they last beyond projects.” In Malawi, this principle was demonstrated through the symbolic handover of a USD 21,000 Pharmacy Assistant scholarship check, part of a program that professionalizes the supply chain workforce and builds long-term capacity.
“There are many more interventions that VillageReach has supported the Ministry of Health on, including the training of Pharmacy Assistants…all of which I cannot fully expound on here due to limited time. I therefore want to applaud VillageReach for all your contributions in Malawi, particularly in the health sector, as you celebrate this 25th anniversary! Congratulations!” — Dr. Samson Mdoolo, Principal Secretary for Health, Malawi Ministry of Health.
Symbolic handover of a USD 21,000 Pharmacy Assistant scholarship check in Lilongwe, Malawi. Photo credit: Cosmas Photography
The Path Forward: A Partnership for Equity
Yet Responsive PHC is also about partnership and trust. No single actor can deliver it alone. Governments, funders, civil society and communities must collaborate in ways that are accountable and rooted in shared purpose. As Mrs. Magret Koskei, Founder of the Chalan Foundation in Nairobi, reminded us: “Community-driven solutions remind us that progress is only real if it reaches the most under-reached.”
Equity, then, is the true measure of responsiveness. Systems must intentionally reach those at the margins: rural households, women and children, displaced populations, so that no one is left behind. Both in Nairobi and Lilongwe, leaders stressed that progress cannot be measured by averages but by whether the most vulnerable experience real improvements in care.
Cutting the 25th Anniversary Cake in Nairobi. Photo Credit: TBK Media
As VillageReach Global Board Member Dr. Norah Obudho concluded: “The journey continues, and progress is only possible through collaboration.” That spirit of collaboration is what has defined VillageReach’s first 25 years and what will drive its 2030 goal to reduce inequities in access to primary health care for 350 million people across Africa.
The next decade presents a critical opportunity to make universal health coverage a promise fulfilled. Responsive PHC offers the clearest path forward. By listening to communities, rooting innovation in government systems, investing in resilient supply chains and keeping equity at the center, we can build health systems that are not only accessible but also adaptive, resilient and people-powered.
At VillageReach, the next 25 years are clear: to continue building health systems that respond to people everywhere and transform health care, together.