This document reflects the work at the 5th annual Primafamed workshop 21-23 November, Victoria Falls, Zimbabwe. It provides an analysis of the PHC context in Sub Sahara Africa and strategic ways to strengthen PHC. Taking into account the diversity in Africa, not all issues, proposals, topics are relevant to all African countries. The document was adopted by consensus and underlines the participants full support to the realisation of the World Health Assembly (WHA) resolution 62.12.