Scandinavian Journal of Primary Health Care

Sustainability in Primary Health Care

Strong primary care is fundamental to any comprehensive, universal, sustainable and effective health care system. However, the sustainability of primary health care is currently under considerable pressure. Decades of great advances in medicine, giving rise to an ever-expanding range of diagnostic and therapeutic options, have contributed to increased life expectancy and improved prognosis for many diseases. However, these successes have also led to a growing prevalence of chronic conditions, multimorbidity and polypharmacy—substantially increasing both the workload and the complexity of primary care.

Increasing focus on preventive care, early diagnosis and lowering thresholds for intervention are widely promoted as key responses to rising health care demand. However, health care resources remain limited—in contrast to demand—necessitating prioritisation. Estimates suggest that more than one-fifth of healthcare resources are spent on low-value care. These insights underscore the importance of prioritising high-value care over interventions of lower value, including preventive treatment at low risk of disease.

Sustainability in primary care extends beyond demographic change and the provision of high-value care. Environmental sustainability is, of course, a central dimension, encompassing issues such as resource use, waste and the environmental impact of healthcare delivery. Workforce-related challenges are also critical as many countries face difficulties in recruitment and retention, while high levels of job-related stress and burnout are widely reported. At the same time, primary care is experiencing an expanding scope of responsibilities, including a continued shift of services from secondary to primary care without commensurate increases in resources. Increased administrative burden further contributes to pressure on the workforce. Despite these challenges, necessity is the mother of invention. Primary care has historically demonstrated a strong capacity for adaptation and innovation and will continue to play a central role in sustainable health care systems.

This Article Collection aims to highlight both challenges and solutions related to Sustainability in Primary Health Care in the context of the Nordic countries. Studies focusing on solutions to sustainability challenges are particularly encouraged. Suitable study types include empirical studies, implementation and evaluation studies, feasibility studies, clinical trials, systematic reviews, theoretical analyses and perspectives.

Potential topics include, but are not limited to:

• Environmental sustainability in primary care
• Low-value care and de-implementation
• Workforce sustainability, recruitment and retention
• Antibiotic stewardship
• Initiatives such as Choosing Wisely

All manuscripts submitted to this Article Collection will undergo a full peer-review; the Guest Advisors for this Collection will not be handling the manuscripts (unless they are an Editorial Board member). 

Please review the journal scope and author submission instructions prior to submitting a manuscript.

The deadline for submitting manuscripts is March 8th 2026.

Please contact Francis Straw at [email protected] with any queries or for information regarding APC discounts in this Article Collection.

Please be sure to select the appropriate Article Collection from the drop-down menu in the submission system. Failure to select the appropriate Article Collection can result in delays.