Activity 01
Research
Study what makes primary healthcare effective, affordable and scalable.
We start from what is already published, then go and count what is not. A district study begins with a facility and workforce census, because a recommendation written against intended capacity rather than real capacity will fail at the first site.
- Evidence reviews with a stated inclusion rule
- Facility, workforce and equipment censuses
- Cohort analysis across the five links of the chain
- A named source and a date on every figure
Activity 02
Policy
Develop frameworks, recommendations and policy guidance for governments.
Recommendations are addressed to systems, budgets and programmes, never to individuals and never to clinicians about a patient. Each recommendation carries what it costs, who pays, and what would have to be true for it to work.
- Policy frameworks and model guidance
- Costed options with an explicit trade off
- Briefings for state and district administrations
- A named counter argument in every document
Activity 03
Measurement
Build indicators, scorecards and tools to assess PHC performance.
An indicator a district cannot collect is not an indicator. We build the smallest set that reveals which link of the chain is breaking, and we specify the collection method tightly enough that the same score means the same thing twice.
- Indicator sets scoped to real collection capacity
- District and facility scorecards
- Cascade instrumentation across all five links
- Baseline first, so a change can be attributed
Activity 04
System design
Help countries redesign care delivery, workforce, financing and referral systems.
Design starts from the constraint, which is almost always workforce or distance. Care pathways, staffing models, payment design and the referral chain are redrawn together, because moving one without the others just relocates the loss.
- Care pathway and referral chain redesign
- Task shifting and workforce models
- Financing and payment design
- Capacity aggregation across public and private providers
Activity 05
Implementation
Work with governments and providers to test, scale and evaluate PHC models.
We stay through the part that is difficult. A pilot gets a stopping rule before it opens. Scale gets a budget line. Evaluation is agreed in advance, so a disappointing result is a finding rather than an argument.
- Pilots with a pre agreed stopping rule
- Scale plans tied to a funded budget line
- Evaluation design fixed before the first site opens
- Handover to an owner who is named in the plan
