Evidence of integrated primary-secondary health care in low-and middle-income countries: protocol for a scoping review

Abstract

Background: Integrated care is a people-centered health delivery approach that ensures the comprehensiveness, quality, and continuity of service across the settings and levels of health systems. The World Health Organization (WHO) recommends integration across levels and building-blocks of health systems as a prerequisite of Universal Health Coverage (UHC). While health systems of low and middle-income countries (LMICs) are often fragmented and led by siloed service delivery structure, several LMICs – including India – have attempted health system integration. Several systematic reviews of evidence on healthcare integration from developed countries exist, but to date, no synthesis from LMICs was reported. This review will provide an overview of existing Integrated Primary Secondary Care Systems (IPSCS) in the context of LMICs, aiming to support policy decisions for the effective integration of health delivery systems in India. Methods: The review will be conducted following the six steps recommend by Arksey and O’Malley. Scientific and grey literature will be systematically selected from PubMed, Embase, Scopus, Web of Science, Global Index Medicus, and electronic repositories of the WHO, World Bank, Health Policy Plus, and OpenGrey. Using a comprehensive search strategy, literature written in English and published between 2000-2019 will be selected, and two independent authors will screen their titles and abstracts. The result will be charted using a data extraction form and reported using tables, figures, and in narrative form. Discussion: No ethical approval is necessary for the review. The review will be conducted between December 2019 and April 2020. The final report will be developed with the consultation of other stakeholders and disseminated through workshops, conference papers, and peer review articles. The review will serve as a guiding tool to approach, implement, and test the IPSCS model in India and other LMICs.

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Integrated Health Care System Application in Patients With Hypertension and Diabetes: A Systematic Review and Meta-analysis

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