Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context

Edelman, Alexandra; Marten, Robert; Montenegro, Hernán; Sheikh, Kabir; Barkley, Shannon; Ghaffar, Abdul; Dalil, Suraya; Topp, Stephanie M.

doi:10.1093/heapol/czab075

Cited by 21 publications

(17 citation statements)

References 92 publications

(185 reference statements)

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“…Therefore, the effective containment of COVID-19 and future epidemics must include determined efforts to restructure African health systems and make them more effective, adaptative, and resilient. This restructuration will also help avoid the interruption of essential services (37,39).…”

Section: Implications For Primary Health Carementioning

confidence: 99%

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study

Bello¹,

Lepeleire²,

Agossou³

et al. 2022

Front.Health Serv.

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IntroductionIn sub-Saharan Africa, there is a need to better understand and guide the practice of primary care physicians (PCPs), especially in a crisis context like the COVID-19 pandemic. This study analyses the experiences of PCPs facing COVID-19 in Benin and draws policy lessons.MethodsThe study followed a fully mixed sequential dominant status design. Data were collected between April and August 2020 from a sample of PCPs in Benin. We performed descriptive analyses on the quantitative data. We also performed bivariate analyses for testing associations between various outcomes and the public/private status of the PCPs, their localization within or outside the cordon sanitaire put in place at the beginning of COVID-19, and their practice' category. A thematic content analysis was done on qualitative data. Results from both analyses were triangulated.ResultsNinety PCPs participated in the quantitative strand, and 14 in the qualitative. The median percentage of the COVID-19 control measures implemented in the health facilities, as reported by the PCPs, was 77.8% (interquartile range = 16.7%), with no difference between the various groups. While 29.4% of the PCPs reported being poorly/not capable of helping the communities to deal with COVID-19, 45.3% felt poorly/not confident in dealing with an actual case. These percentages were bigger in the private sector. The PCP's experiences were marked by anxiety and fear, with 80.2% reporting stress. Many PCPs (74.1%) reported not receiving support from local health authorities, and 75.3% felt their concerns were not adequately addressed. Both percentages were higher in the private sector. The PCPs especially complained of insufficient training, insufficient coordination, and less support to private providers than the public ones. For 72.4 and 79.3% of the PCPs, respectively, the pandemic impacted services utilization and daily work. There were negative impacts (like a decrease in the services utilization or the quality of care), but also positive ones (like improved compliance to hygiene measures and new opportunities).ConclusionOur study highlighted the need for more structured support to PCPs for optimizing their contribution to epidemics control and good primary healthcare in Benin. Efforts in this direction can build on several good practices and opportunities.

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Section: Implications For Primary Health Carementioning

confidence: 99%

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study

Bello¹,

Lepeleire²,

Agossou³

et al. 2022

Front.Health Serv.

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“…But while universal health coverage (UHC) is one of the main development goals adopted by the United Nations and the World Health Organization (WHO), the COVID-19 crisis has clearly shown that achieving UHC at a sufficiently optimal level and protection of the most vulnerable population groups remains an unresolved problem even for the richest countries. Therefore, many health professionals and WHO experts propose number of measures to increase the resilience of health systems to ensure universal health coverage and health security during the COVID-19 pandemic and beyond [29,30].…”

Section: Un Political Declaration On Universal Healthmentioning

confidence: 99%

The Covid-19 Pandemic, Universal Health Coverage and Primary Health Care Strengthening

Brimkulov

Sydykova²,

Aralbaeva³

et al. 2022

IAM

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In light of the COVID-19 pandemic, this article provides a review of the literature on the development of the World Health Organization (WHO) universal service coverage concept, starting with the 1978 Declaration of Alma-Ata on Primary Health Care, including the 2018 Declaration of Astana as an integral basis for all comprehensive healthcare systems.WHO Political Declaration 2019. The development of primary health care in the CIS countries followed different scenarios, often deviating from the principles of the Alma-Ata Declaration. In the Analytical review of the organization on the provision of medical services in the Kyrgyz Republic during the reform of health care, the basic principles of PHC and family medicine were also implemented with distortions, which played a negative role in the context of the pandemic. The COVID-19 pandemic has rejected all countries on the path to universal health care, but also demonstrated the critical role of the absence or insufficiency of sustainable and high-quality primary health care, tested the strength of health systems around the world, highlighting the urgent need to achieve universal health care coverage, which is only possible with strong primary health care.

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“…The PHC approach incorporates multisectoral policy and actions and emphasises human dignity and rights [ 12 ]. Community-based PHC systems could provide comprehensive, affordable, and acceptable health services at the first point of contact in the PHE contexts [ 13 , 14 ]. Responses to PHEs can be ensured by developing interdisciplinary teams, designing comprehensive interventions, and working with civil societies and communities [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Preparedness, impacts, and responses of public health emergencies towards health security: qualitative synthesis of evidence

Khatri,

Endalamaw,

Erku

et al. 2023

Arch Public Health

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Background Natural and human-made public health emergencies (PHEs), such as armed conflicts, floods, and disease outbreaks, influence health systems including interruption of delivery and utilization of health services, and increased health service needs. However, the intensity and types of impacts of these PHEs vary across countries due to several associated factors. This scoping review aimed to synthesise available evidence on PHEs, their preparedness, impacts, and responses. Methods We conducted a scoping review of published evidence. Studies were identified using search terms related to two concepts: health security and primary health care. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines to select studies. We adapted the review framework of Arksey and O’Malley. Data were analyzed using a thematic analysis approach and explained under three stages of PHEs: preparedness, impacts, and responses. Results A total of 64 studies were included in this review. Health systems of many low- and middle-income countries had inadequate preparedness to absorb the shocks of PHEs, limited surveillance, and monitoring of risks. Health systems have been overburdened with interrupted health services, increased need for health services, poor health resilience, and health inequities. Strategies of response to the impact of PHEs included integrated services such as public health and primary care, communication and partnership across sectors, use of digital tools, multisectoral coordination and actions, system approach to responses, multidisciplinary providers, and planning for resilient health systems. Conclusions Public health emergencies have high impacts in countries with weak health systems, inadequate preparedness, and inadequate surveillance mechanisms. Better health system preparedness is required to absorb the impact, respond to the consequences, and adapt for future PHEs. Some potential response strategies could be ensuring need-based health services, monitoring and surveillance of post-emergency outbreaks, and multisectoral actions to engage sectors to address the collateral impacts of PHEs. Mitigation strategies for future PHEs could include risk assessment, disaster preparedness, and setting digital alarm systems for monitoring and surveillance.

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Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context

Cited by 21 publications

References 92 publications

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study

Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study

The Covid-19 Pandemic, Universal Health Coverage and Primary Health Care Strengthening

Preparedness, impacts, and responses of public health emergencies towards health security: qualitative synthesis of evidence

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