ArticleThe European journal of general practice2026
Strengthening Primary Health Care in Europe: A Delphi study towards accessibility, equity and continuity of care.
Article in The European journal of general practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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12 authors.
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Abstract
introductionStrengthening Primary Health Care (PHC) is essential for building resilient and equitable health systems, but PHC faces barriers in implementation, resource allocation, and political prioritisation. This study aimed to develop a strategic roadmap to enhance PHC by identifying core values, priorities, and actionable strategies through expert consensus.
methodsA two-round Delphi study was conducted with 210 stakeholders from 35 countries, including PHC professionals, policymakers, and public health experts. Participants evaluated the importance, feasibility, and policy prioritisation of key PHC values. Quantitative data were analysed using descriptive statistics.
resultsThe response rate was 81.4% (171/210) in round one and 73.5% (97/132) in round two. The majority of participants (89%) had a background in medicine. A consensus (>80% agreement) was reached in the first round regarding PHC values. Key recommendations included increasing investment in PHC workforce development, particularly in underserved areas; strengthening health information systems and integrating telehealth solutions; enhancing PHC governance models to support multidisciplinary collaboration and citizen-centred care; and adapting processes to improve chronic care management, end-of-life support, and standardised assessment frameworks. In the second round, when participants assessed the feasibility of these recommendations, agreement levels ranged from 61 to 92%. When asked about the policy prioritisation of these measures, agreement dropped, ranging from 22 to 51%.
conclusionsThis study highlights that PHC stakeholders perceive a critical need to align health policies with the core values of PHC, while addressing systemic barriers to implementation. Future efforts should focus on bridging the perceived gap between expert recommendations and political prioritisation to achieve sustainable PHC improvements.
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