latvia is moving in that direction with a primary health care development plan that strives to improve quality and accessibility of health services and enhances preventive activities to keep people out of more expensive hospital care latvia has demonstrated that it can use its workforce innovatively to improve access to primary care but needs to strengthen the role that gps and other health care professionals play in health promotion particularly educating patients about chronic disease selfmanagement section describes the structure of the latvian primary health care system and workforce and other challenges