Primary Health Care in the World Bank's COVID-19 Multiphase Programmatic Approach Portfolio Response : The Extent to Which Pandemic Response Activities Were Planned at the Primary Health Care Level within the World Bank's COVID-19 MPA Projects

Soon after the World Health Organization (WHO) declared a pandemic, the World Bank made available rapid financing to strengthen countries' ability to respond to COVID-19 through a multiphase programmatic approach (MPA). The MPA's immediate objective is to prevent, detect, and respond to the COVID-19 pandemic. By July 2020, the World Bank's board of directors had approved financing for 74 countries. This evaluation aims to determine the extent to which response activities were planned at the primary health care (PHC) level, and the extent to which PHC was leveraged within the first wave of MPA projects was determined by the number of PHC activities listed in the project components and indicators. Of 74 projects evaluated, 70 (94 percent) had at least one PHC-related activity listed in the components. Frequently planned activities at the PHC level primarily included surveillance, handwashing, and community engagement-related activities. MPA projects did not prioritize a commitment to maintaining essential service delivery at the PHC level. Several projects showed a greater commitment to integrating response activities at the PHC level, including Cote d'Ivoire, Egypt, Liberia, and Papua New Guinea, Senegal, the Republic of Congo. Notably, except for Egypt and Papua New Guinea, these projects were in countries that have been affected or threatened by the Ebola pandemic. These countries emphasized the integration of pandemic response activities at the community level. Overall, this evaluation highlights three takeaways: (1) the most common project activities related to PHC focused on surveillance, community engagement, and disease prevention; (2) among MPA projects, those in the sub-Saharan African region integrated more pandemic response activities at the PHC level than did other regions; and (3) maintaining essential primary health care services was not a priority among MPA projects in the initial phase of the response