Integrating primary care and public health to enhance response to a pandemic

Abstract

Primary health care (PHC) includes both primary care (PC) and essential public health (PH) functions. While much is written about the need to coordinate these two aspects, successful integration remains elusive in many countries. Furthermore, the current global pandemic has highlighted many gaps in a well-integrated PHC approach. Four key actions have been recognized as important for effective integration. A survey of PC stakeholders (clinicians, researchers, and policy-makers) from 111 countries revealed many of the challenges encountered when facing the pandemic without a coordinated effort between PC and PH functions. Participants’ responses to open-ended questions underscored how each of the key actions could have been strengthened in their country and are potential factors to why a strong PC system may not have contributed to reduced mortality. By integrating PC and PH greater capacity to respond to emergencies may be possible if the synergies gained by harmonizing the two are realized.

Resilience of the primary health care system – German primary care practitioners’ perspectives during the early COVID-19 pandemic

“…Primary care physicians played an important role in the coordination process, for example, through active participation in knowledge transfer, integration into crisis management teams, appointment of the new ASHIP pandemic officer, or inclusion in regional strategic efforts, so that a high level of resiliency was also seen in the dimensions knowledge and legitimacy , a resiliency that can still be expanded further despite the heterogeneity and, in part, initially delayed responses. The need to include primary care physicians in coordinating processes is a topic that is also covered internationally [ 6 , 10 , 31 ]. The relevance of information and communication channels in the context of a pandemic is being reported on internationally [ 6 , 10 , 26 , 31 ].…”

“…The need to include primary care physicians in coordinating processes is a topic that is also covered internationally [ 6 , 10 , 31 ]. The relevance of information and communication channels in the context of a pandemic is being reported on internationally [ 6 , 10 , 26 , 31 ].…”

Priority setting and cross-country learning: the relevance of TO-REACH for primary care

“…First and foremost, the role of primary care in the response to the COVID-19 pandemic differs greatly between European countries and therefore provides opportunities for cross-country learning (EXPH, 2020). The pandemic has worked as a catalyst to become aware of existing problems and has thereby shown the importance of transformation of health care systems, for example further integration of parts of the health care system with social care (Kinder et al, 2021). Care processes have changed through the quick introduction of innovations in the use of ICT, particularly electronic consultations.…”

International examples of primary care COVID-19 preparedness and response: a comparison of four countries

“…Lack of involvement of PC and poor integration with PH in the COVID-19 response has been identified in other countries. This was a key theme in a 2020 international study looking at the pandemic response in 111 countries,16–18 and has also been recognised in a number of European studies 19–21. PC frequently demonstrates agility and innovative capacity in the face of limited resources and a changing environment22 contributing to the resilience required in the face of pandemics.…”