Strategies for integrating primary health services in low- and middle-income countries at the point of delivery

Abstract

Strategies for integrating primary health services in low-and middle-income countries at the point of delivery (Review)

Delivery arrangements for health systems in low-income countries: an overview of systematic reviews

“…Outcomes examined included patient outcomes, access to care, coverage, utilisation of health services, quality of care, resource use, social outcomes (social isolation), impacts on equity, healthcare provider performance and adverse effects. Four reviews included two comparisons each (Dudley 2011;Hansen 2011;Pasricha 2012;, and another three reviews, three comparisons each (Butler 2011;Handford 2006;Theodoratou 2010), so the total number of comparisons evaluated in the 51 included reviews was 60 (Appendix 3 provides details of interventions and comparisons). We grouped the delivery arrangements in eight categories, seven pre-specified in the protocol and an additional one for complex interventions that cut across categories of delivery arrangements and included components that were not delivery arrangements (i.e.…”

“…Adding a service to an existing service and integrating delivery models A review compared integration to usual care and included nine studies (Dudley 2011). Integration brings together the inputs, delivery, management and organisation of particular service functions in order to improve care at the point of delivery.…”

“…Integration: adding a service to an existing service and integrated delivery models A review of the effects of integration compared to usual care found that integrated community and facility provision of HIV prevention and control leads to little or no difference in the proportion of STIs treated effectively in women (high-certainty evidence) and results in little or no difference in STI or HIV incidence in the population (high-certainty evidence) (Dudley 2011). …”

“…However, only five reviews reported adverse effects (Dudley 2011;Martínez-González 2014;Ngo 2013;Parker 2013;Wilson 2011), and one review did not find any studies reporting adverse effects (Van Lonkhuijzen 2012). Wilson 2011 reported undesirable effects on patient outcomes, and Dudley 2011 on access, coverage or utilisation, both with low-or very low-certainty evidence.…”

“…• Adding a new health service to an existing service and integrating services in health care delivery (Dudley 2011) • Integrating vaccination with other healthcare services (Oyo-Ita 2016)…”