How major international development organisations operationalise primary health care: a thematic content analysis of strategy documents.

Despite consensus around the need to prioritise primary health care (PHC), misaligned interpretations of this concept have real-world consequences for implementation. Here, we analysed how 30 major international development organisations operationalise PHC in their corporate strategy documents through thematic content analysis. The findings reveal that despite high-level endorsement for PHC, fewer than half of the reviewed documents explicitly mentioned PHC. Among those that did, PHC was conceptualised in varying ways: as a service delivery platform, level of care, bundle of interventions, or whole-of-society approach to health. From these conceptualisations, three different interpretations of PHC emerged-namely, the intended whole-of-society approach to health, strong or high-quality primary care, and selective or basic primary care. Integral components to PHC, including empowered people and communities and multisectoral action, were largely absent. These findings highlight the opportunities and urgency for improved alignment across international organisations to support a consistent approach aligned with the original vision of PHC.