Untangling Ambiguity: What is a Primary Health Care-Oriented Model of Care?
Deena Al Asfoor,
Tobias Kasper,
Hamid Ravaghi,
Awad Mataria
Abstract
Despite being at the top of the UN Agenda, Universal Health Coverage (UHC) is a challenging goal for
countries. Empowering countries to progress towards UHC involves prioritizing the primary healthcare
approach, for which Models of Care is one important lever that is vaguely understood.
In this paper, we discuss the Models of Care, which refer to the way in which health services are organized
and delivered, including the processes of care, the organization of providers, and the management of
services.
Elements that make up a macro-level care model include: 1) Population: the groups eligible for health
services; 2) Services: the types and range of services offered; 3) Service design or delivery platforms:
the platforms such as primary, secondary, tertiary, and community, along with their roles, functions, and
definitions; 4) Service organization and management: including care pathways, which involve organizing
services—covering empanelment, first-contact access, and gatekeeping—and managing facilities and
administrative systems; 5) Community engagement: involving patient groups and community health
workers, empowering participation through health education, shared decision-making, and other
methods; and 6) Financing model: a flexible, fit-for-purpose structure that supports the health system
effectively to create a supportive environment for MoC.
As outlined, the components of a Model of Care can provide a structured framework for countries
aiming to evaluate their health systems, enhance access to healthcare and financial protection for their
populations, and optimize resource utilization. Detailed guidance based on these components can serve
as a clear benchmark for implementing a custom national MoC.
