primærhelsetjenesten

Primærhelsetjenesten is the first level of contact in the Norwegian health system. It is largely delivered by municipalities and includes preventive and curative care provided outside hospitals. Key components are general practice (the fastlegeordningen), municipal health and care services, home-based care, health centres (helsehus) with staff such as district nurses, physiotherapists, midwives, and mental health workers, and preventive services for children and families. It provides both medical treatment and ongoing care to individuals and families in the community.

Organization and responsibilities: The general practitioner (fastlege) system assigns each resident a regular GP who coordinates most non-emergency care. Municipalities plan and deliver services such as home care, nursing homes, school health services, and home-visit programs. Preventive measures typically include immunizations, screenings, maternity and child health initiatives, and health promotion activities. The primærhelsetjenesten also encompasses rehabilitation, dental services in municipal settings, and certain social and public health supports.

Relation to secondary care and reforms: Primærhelsetjenesten operates in close connection with specialist health services, which are hospital-based. The Coordination Reform (Samhandlingsreformen) initiated around 2012 aimed to strengthen cooperation between levels of care, improve discharge planning, and ensure more care is provided closer to people’s homes, with greater focus on integrated services and follow-up.

Governance and goals: Services are funded and organized at the municipal level under national guidelines, with the state setting framework conditions and standards. The overarching goals are accessible, continuous, and equitable care, emphasizing patient participation, coordination among providers, and sustainable health outcomes.