Reorienting Hospitals and National Health Systems Towards Primary Health Care and Public Health to Accelerate and Scale Up towards WHO-Universal Health Coverage and UN-SDG-Health 3 by 2030.
1
Department of Family and Health Sciences, Women's University in Africa, Harare, Zimbabwe
2
Secretariat, Zimbabwe College of Public Health Physicians, Harare, Zimbabwe
3
School of Public Health, Fudan University, Shanghai, China
4
Midlands Province, Gweru Provincial Hospital, Gweru, Zimbabwe
5
Head Office, Ministry of Health and Child Care, Harare, Zimbabwe
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Progress towards Universal Health Coverage (UHC) and Sustainable Development Goal 3 (SDG3) remains uneven, with countries experiencing stagnation and patients facing catastrophic financial expenditure. WHO member countries operate poor-quality hospital-centric, curative health systems and underinvest in public health, and are unable to balance population health with health system strengthening. This limits efficiency, sustainability, and the ability to address the escalating disease burden and environmental and occupational threats, in low- and middle-income countries.
OBJECTIVE:
To examine the value of reorienting hospitals and health systems towards revitalizing Primary Health Care and Public Health, as a health policy strategy for achievement of UHC and SDG3 targets by 2030.
METHODS:
A health policy-oriented narrative review was undertaken. Analysis focused on comparative effectiveness, equity, efficiency, and resilience of PHC oriented versus hospital-centric health system models. Domains: hospital leadership, governance, management, health financing, hospital workforce, and community-based service delivery.
RESULTS:
Public health-led and PHC hospitals and health systems equitably and cost-effectively deliver essential services, improve access, and reduce avoidable hospital utilisation and catastrophic health expenditure. (Reoriented hospitals function more effectively with appropriate referral networks, supporting population-based care rather than isolated, fragmented curative services; while reducing avoidable hospital admissions and catastrophic health expenditure). Countries prioritising PHC and public health demonstrate improved performance across SDG 3 indicators, including maternal and child health, and management of communicable and non-communicable diseases.
CONCLUSIONS:
Reorienting hospitals and health systems towards Public Health and PHC will accelerate UHC and SDG 3 achievement. This requires prioritizing hospital coordination, administration/management, health systems strengthening, hospital outreach, and mentorship programs. This can be achieved through health professional associations and colleges, politicians, policy makers, people mobilization, financial reallocation, strengthened public health capacity, and governance reform. Without such reorientation, countries continue to risk widening inequities, failing to meet global health targets, and increasing threats to health security.
Progress towards Universal Health Coverage (UHC) and Sustainable Development Goal 3 (SDG3) remains uneven, with countries experiencing stagnation and patients facing catastrophic financial expenditure. WHO member countries operate poor-quality hospital-centric, curative health systems and underinvest in public health, and are unable to balance population health with health system strengthening. This limits efficiency, sustainability, and the ability to address the escalating disease burden and environmental and occupational threats, in low- and middle-income countries.
OBJECTIVE:
To examine the value of reorienting hospitals and health systems towards revitalizing Primary Health Care and Public Health, as a health policy strategy for achievement of UHC and SDG3 targets by 2030.
METHODS:
A health policy-oriented narrative review was undertaken. Analysis focused on comparative effectiveness, equity, efficiency, and resilience of PHC oriented versus hospital-centric health system models. Domains: hospital leadership, governance, management, health financing, hospital workforce, and community-based service delivery.
RESULTS:
Public health-led and PHC hospitals and health systems equitably and cost-effectively deliver essential services, improve access, and reduce avoidable hospital utilisation and catastrophic health expenditure. (Reoriented hospitals function more effectively with appropriate referral networks, supporting population-based care rather than isolated, fragmented curative services; while reducing avoidable hospital admissions and catastrophic health expenditure). Countries prioritising PHC and public health demonstrate improved performance across SDG 3 indicators, including maternal and child health, and management of communicable and non-communicable diseases.
CONCLUSIONS:
Reorienting hospitals and health systems towards Public Health and PHC will accelerate UHC and SDG 3 achievement. This requires prioritizing hospital coordination, administration/management, health systems strengthening, hospital outreach, and mentorship programs. This can be achieved through health professional associations and colleges, politicians, policy makers, people mobilization, financial reallocation, strengthened public health capacity, and governance reform. Without such reorientation, countries continue to risk widening inequities, failing to meet global health targets, and increasing threats to health security.
| eISSN: | 2654-1459 |
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