Reimagining primary health care: more of the same is not enough

One of the major achievements in global development, especially in global health, is the incredible progress in child survival. Since the launch of the Millennium Development Goals in 2000, the number of young child deaths has dropped significantly to unprecedented levels. We strongly suggest that low- and middle-income countries take the lead in reimagining and redesigning their own PHC systems. They should conduct a detailed situational analysis of the health sector to identify major policy gaps and implementation challenges, particularly focusing on fixing the broken "vital organs" of the PHC system. It is equally important to identify and address the demand-side difficulties that hinder the utilization of health services. Priority should be given to improving access and expanding services for the most vulnerable groups in society. Most maternal and child deaths are concentrated among socially disadvantaged and marginalized populations, especially those living in remote areas, rural communities, and urban slums. It is imperative to acknowledge that the highest quality health services are not free. If LMICs are committed to optimizing their PHC systems and transforming their health sectors to be more efficient and effective, they must be prepared to cover incremental costs through improved health budgeting and innovative health financing mechanisms. This includes actively engaging communities to support the PHC system both financially and in-kind.