Abstract
At the beginning of the twenty-first century, the World Health Report 2000 of the World Health Organization (WHO) identified many countries falling short of their performance potential (World Health Organization 2000). The World Health Report 2008, focusing on the 30th anniversary of the Declaration of Alma-Ata on Primary Health Care, urged all countries to re-orientate their health systems towards strengthened primary care (World Health Organization 2008). Despite caveats on generalizability, the available evidence confirms that a strong primary care orientation results in improved population health outcomes and equity, more appropriate utilization of services, greater user satisfaction and lower health system costs (World Health Organization 2004). The value of a strengthened primary care system is increasingly recognized by policymakers worldwide (Starfield 2009).
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