Exemplars in Primary Health Care

The Center for Global Digital Health Innovation (CGDHI) based at the Johns Hopkins Bloomberg School of Public Health and eHealth Lab Ethiopia based at the University of Gondar is working with the Bill & Melinda Gates Foundation to understand which countries have been able to successfully leverage digital solutions to transform PHC service delivery Рand the facilitators and challenges experienced in their paths. This work is part of the larger Exemplars in Global Health initiative. To support this work, we are engaging stakeholders from countries that can benefit from the findings and adapt them for their country contexts.


The primary outcome of this project is to identify countries that are exemplars in either achieving or making rapid gains in the performance of primary health care, relative to resources spent; and identify the health system strengthening mechanism and actions used to do so. Ultimately, we envisage that the outputs of this effort will inform low- and middle-income countries seeking to extend the impact of each dollar spent on primary health care.

We will identify, measure, and explore PHC efficiency, considering the affordability, coverage, and quality of PHC services and their broader impact on the health system. The scope of work will be the mechanisms and actions to improve efficiency defined by the decision space of the Ministry of Health, including inter-sectoral action between the health sector and other sectors, and public/ private collaboration. We expect the results of our analysis to inform decision-making regarding how countries allocate available resources for PHC, as well as health system design and management approaches that countries use to maximize the effectiveness of their available resources, and collaboration across sectors and ministries.

The research will encompass a series of mixed methods case studies, with additional cross-country analyses both at the start to identify exemplars and at the end to synthesize lessons across the case studies.

Activities and Outcomes

  • Five Exemplar Countries whose journeys to strengthening the delivery of PHC services through digital transformation are identified and engaged with for retrospective analyses.
  • Key research questions, study learning opportunities, and dissemination objectives are prioritized based on the identified needs of the prospective countries
  • Advanced understanding of factors that facilitated the effective implementation of digital strategies to yield improvements in the delivery of PHC services in each of the five retrospective Exemplar Countries
  • Cross-country data analyses and syntheses of facilitators of improvement – including case studies of factors that limited the effectiveness of digital interventions, and accounting for variations in country ecosystems that may require adaptation – are documented.
  • Critical learnings from the five retrospective Exemplar Countries are disseminated in the retrospective Exemplar Countries, prospective countries, and broadly.

  • Gete Ventures
  • Bill and Meldina Gates Foundation
  • World Bank
  • Center of Global Digital Health Innovation, JOHNS HOPKINS Bloomberg School of Public Health

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