The use of proverbs in Africa is a powerful communication tool. Proverbs alert the listener to the importance of a topic and convey ancestral wisdom often with richly evocative imagery. The beauty of proverbs is their universal and timeless truths, which incorporate multiple interpretations across domains, cultures, and countries. It is fitting to use the interpretations of this West African (Akan) proverb “Wood already touched by fire is not hard to set alight” as a framework to comment on the study in Pediatrics by Fiori et al, who report the impact of a pragmatic, effectiveness primary health care (PHC) suite of interventions across 10 022 households over a 5-year period in Kara, a low-resource region of northern Togo, West Africa. The authors report on mortality, health use, quality and coverage outcomes, and cost.

This year marks the 43rd anniversary of the landmark Alma-Ata Declaration, which codified PHC as the...

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