Primary Health Care

Health worker vaccinating a baby in Madagascar

Strengthening Sustainable Improvements in Quality of Care

Through the USAID ACCESS program, our goal is to reach 16 million people in 14 of Madagascar’s 26 regions with reproductive, maternal, newborn, child, and adolescent health services; improve gender equity; and reduce gender-based violence. ACCESS’ primary health care interventions include improving newborn resuscitation practices in health facilities to reduce preventable neonatal mortality from asphyxia, which is the second leading cause of death among Malagasy newborns. Through ACCESS, we support donations of newborn resuscitation equipment, health worker clinical trainings, awareness-raising efforts at the community level with pregnant women on pregnancy danger signs, and correct documentation and reporting of newborn resuscitation. Between 2021 and 2022, in the 11 ACCESS-supported regions, the successful newborn resuscitation rate in health centers increased from 74.5% to 80.6%. 

Building Person-Centered, Integrated Local Systems for Primary Health Care

Primary health care is critical to ensuring that health care is equitable and meets the needs of individuals and communities. A strong, responsive, and sustainable primary health care system is essential for achieving universal health coverage, maintaining population health, and preventing the spread of infectious disease while reducing the burden of noncommunicable diseases and health care costs. Primary health care acts as the first point of contact with the health system and provides integrated, person-centered care to communities across the continuum of care—from prevention to treatment to rehabilitation or palliative care.

By providing care in the community, as well as care through the community, primary health care addresses not only individual and family health needs but also the broader issue of public health and the needs of defined populations.  At MSH, all of our current projects contain primary health care, a pillar of our health systems strengthening approach, as we work with governments and local organizations to facilitate strong health systems that are affordable and accessible, responsive to people and their communities, and provide lifesaving health services at every stage of life. 

Our approach: 

  • Delivers high quality primary health care by serving as the first point of contact for all people and providing continual, comprehensive, coordinated, and person-centered care across the lifespan 
  • Meets people’s health needs throughout their lives 
  • Addresses the broader determinants of health through multisectoral policy and action 
  • Empowers individuals, families, and communities to take charge of their own health 


MSH supports integrated packages of health services with people-centered care models and has strengthened the capacities of health systems—from the policy level to last-mile service delivery—to implement them. Our current and recent work includes: