Emergency ready primary health care framework

What this guideline says

GMJ summary

The Emergency Ready Primary Health Care (ERPHC) framework provides a comprehensive approach to integrating emergency preparedness and response capacities within routine primary health care systems. It addresses persistent gaps exposed during COVID-19 and other health emergencies, where PHC systems often lacked adequate capacity for early detection, infection prevention and control, and continuity of essential services during crises.

The framework is structured around four interdependent capacities: Connect (trusted community engagement and risk communication), Detect (timely identification and reporting of health threats through surveillance), Protect (safe service delivery through IPC, resilient infrastructure, and health worker protection), and Treat (effective case management and service continuity during emergencies). These capacities work together to deliver three core system outputs: speed (rapid detection and response), safety (protection of health workers, patients and communities), and surge (capacity to absorb increased demand while sustaining services).

The framework aligns with global commitments including the International Health Regulations (2005), the health emergency prevention, preparedness, response and resilience (HEPR) framework, the Sendai framework for disaster risk reduction, and the operational framework for primary health care. It is designed to be flexible and context-adaptable, with implementation across national, subnational, facility and community levels. A complementary operational guide provides practical tools for contextualized implementation, including self-assessment instruments, prioritization matrices, and monitoring frameworks.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. The 7-1-7 target for epidemic response requires detection within 7 days of outbreak emergence, notification to authorities within 1 day, and essential early response actions completed within 7 days—functions that depend critically on PHC system performance
2. Connect capacity includes designating RCCE focal points at PHC facility and district levels, establishing standard operating procedures for two-way community communication, and training community health workers as trusted influencers within communities
3. Detect capacity requires surveillance focal points at PHC facilities, trained health workers for detection and reporting of priority diseases, functional referral systems between primary, secondary and tertiary care, and point-of-care diagnostics with specimen collection and transportation mechanisms
4. Protect capacity mandates IPC and WASH focal points at facilities, health worker training in IPC and antimicrobial stewardship, PHC facilities equipped with climate-resilient WASH infrastructure, essential IPC supplies through strengthened supply chains, and functional cold chain infrastructure for routine and emergency immunization
5. Treat capacity requires national policies and SOPs for emergency case management and continuity of essential services, functional CHW networks for integrated community case management, screening and triage systems operationalized within PHC facilities, and strategic stockpiles of essential medicines, supplies and personal protective equipment maintained at PHC level
6. Multi-country pilot implementation (2023-2025) in Ethiopia, Nigeria, Sierra Leone and Uganda demonstrated that routine mentorship and integrated strengthening of all four capacities produces rapid, measurable improvements in frontline performance including strengthened 7-1-7 detection and notification, improved facility readiness, and increased health worker confidence
7. The framework emphasizes that 61% of outbreak detection bottlenecks occur at health facility level, with low clinical suspicion among frontline health workers identified as the most frequent gap—underscoring the critical need for PHC-level preparedness
8. Implementation requires alignment across national (policies, standards, health information systems, supply chains), subnational (planning, supervision, data analysis), facility (triage, surveillance, case management, IPC), and community levels (CHWs, outreach, community surveillance, preparedness)

ERPHC core capacities, system outputs and expected outcomes

Table extracted from the guideline

Source: World Health Organization, Emergency ready primary health care framework. Reproduced in summary form.

From the guideline

Verbatim

“Multi-country analyses of 7-1-7 performance have shown that 61% of outbreak detection bottlenecks occurred at the health facility level, with low clinical suspicion among frontline health workers identified as the most frequent gap.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

Quick answers

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