Introduction. The main problems and directions of the development of primary health care are considered- the most affordable, economically and socially acceptable type of mass medical care that ensures the effectiveness of the entire health care system, taking into account the position and recommendations of WHO, in the context of the implementation of the National Health Care Project and the modernization of primary health care. Purpose: to identify the main problems and strategic directions for the development of primary health care in the Russian Federation, ways to increase the efficiency of the processes of activity of medical organizations of primary health care. Material and methods: content analysis, synthesis, the method of expert assessments, statistical analysis, comparative analysis. Results. The main problems associated with the continuing need and dissatisfaction of citizens with primary health care, with staffing, production processes, preventive measures, informatization of the activities of medical organizations providing primary health care are identified. The causal relationships of the identified problems with the measures taken in the field of PHC development in the Russian Federation are established. Conclusion. The problems of accessibility and quality of primary health care, increasing the satisfaction of the population, the effectiveness of the activities of medical organizations have remained relevant for many years and, along with programmatic measures for the development, modernization, and improvement of the availability and quality of medical care, require improving the internal processes of functioning of medical organizations providing primary health care through the introduction of new models of intensification of the processes of the medical organization. The key success factor in the organization of production activities is the balance of the number and structure of medical personnel to the volume of activities performed, tasks and areas of modernization of primary health care taking into account the needs of the population, their effective use, advanced training, updating, concretization and adequacy of the composition of competencies acquired in the process of training to the performed labor functions and labor actions.