Skip to main content

ETHNOS_APP

Home • Search • Journals • List 0

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

Bibliographic Data

ID16763203
AuthorsAlexandra Edelman (0000-0002-2021-5266, James Cook University), Rainer Martens (0000-0002-2416-2309, Alliance for Health Policy and Systems Research, World Health Organization, Switzerland), Robert Marten, Hernán Montenegro (Special Programme on Primary Health Care, World Health Organization, Geneva, Switzerland), Kay Sheikh (0000-0003-4755-2075, World Health Organization), Kabir Sheikh (Alliance for Health Policy and Systems Research, World Health Organization, Switzerland), Shannon Barkley (0000-0002-8216-9453, Special Programme on Primary Health Care, World Health Organization, Geneva, Switzerland), Abdul Ghaffar (0000-0002-5994-8440, Alliance for Health Policy and Systems Research, World Health Organization, Switzerland), Suraya Dalil (0000-0003-1841-5610, Special Programme on Primary Health Care, World Health Organization, Geneva, Switzerland), Stephanie M Topp (0000-0002-3448-7983, James Cook University, corresponding author)
Year2021
Volume36
Issue7
Pages1163-1186
Publication date2021-08-12
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czab075
PMID34185844
OpenAlexW3173654117
LanguageEN
Citations received6
References cited46

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of ‘Health for All’. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework. A scoping review design was adopted to summarize evidence from a diverse body of literature with a modification to accommodate four discrete phases of searching, screening and eligibility assessment: a database search in PubMed for PHC-related literature reviews and multi-country analyses (Phase 1); a website search for key global PHC synthesis reports (Phase 2); targeted searches for peer-reviewed literature relating to specific components of PHC (Phase 3) and searches for emerging insights relating to PHC in the COVID-19 context (Phase 4). Evidence from 96 included papers were analysed across deductive themes corresponding to the three main components of PHC. Findings affirm that investments in PHC improve equity and access, healthcare performance, accountability of health systems and health outcomes. Key enablers of PHC implementation include equity-informed financing models, health system and governance frameworks that differentiate multi-sectoral PHC from more discrete service-focussed primary care, and governance mechanisms that strengthen linkages between policymakers, civil society, non-governmental organizations, community-based organizations and private sector entities. Although knowledge about, and experience in, PHC implementation continues to grow, critical knowledge gaps are evident, particularly relating to country-level, context-specific governance, financing, workforce, accountability and service coordination mechanisms. An agenda to guide future country-specific PHC research is outlined

Accountability · Business · Context (archaeology) · Corporate governance · Declaration · Equity (law) · Geography · Global health · Grey literature · Health care · MEDLINE · Political science · Public health · Public relations · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Primary Care and Health Outcomes

  • Governance, coordination, and accountability in public health emergency preparedness and response

    Open Access•Sileshi Demelash, Melkamu Asrat Alava et al.•PLOS Global Public Health•2026

  • Role of a primary healthcare approach in Covid-19 pandemic response in the eastern Mediterranean region

    Open Access•Fadi El-Jardali, Nour Ataya et al.•BMJ Global Health•2025

  • Primary health care in the context of the Covid-19 pandemic in 10 South-East Asian countries

    Open Access•Alexandra Edelman, Rainer Martens et al.•BMJ Global Health•2025

  • An unfinished agenda

    Open Access•Alexandra Edelman, Lluis Vinyals Torres et al.•BMJ Global Health•2025

  • Status of countrywide laboratory services quality and capacity in primary healthcare facilities in Tanzania

    Open Access•Erick S Kinyenje, Ruth R Ngowi et al.•PLOS Global Public Health•2023

  • How to cut child mortality in half again

    Open Access•Susanne Carai, Sophie Jullien•Journal of Global Health•2026

  • Revisiting Alma-Ata

    Open Access•Thomas Hone, James Macinko et al.•The Lancet•2018

  • Community health workers reveal Covid-19 disaster in Brazil

    Open Access•Gabriela Lotta, Clare Wenham et al.•The Lancet•2020

  • Has Covid-19 subverted global health?

    Open Access•Richard Cash, Richard A Cash et al.•The Lancet•2020

  • Community participation is crucial in a pandemic

    Open Access•Cicely A Marston, Cicely Marston et al.•The Lancet•2020

  • Embedded research to advance primary health care

    Open Access•Soumya Swaminathan, Kay Sheikh et al.•BMJ Global Health•2020

  • Community health workers for pandemic response

    Open Access•Soumyadeep Bhaumik, Sandeep Moola et al.•BMJ Global Health•2020

  • Reclaiming comprehensive public health

    Open Access•Rene Loewenson, Kirsten Accoe et al.•BMJ Global Health•2020

  • Paradigms, policies and people

    Open Access•Susan Beth Rifkin•BMJ Global Health•2020

  • Revisiting the equity debate in Covid-19

    Open Access•Angela Ballantyne, William Rogers et al.•Journal of Medical Ethics•2020

  • Citizens and Service Delivery

    World Bank, Dena Ringold et al.•Citizens and service delivery•2012

  • Ações federais para apoio e fortalecimento local no combate ao Covid-19

    Open Access•Erno Harzheim, Caroline Martins et al.•Ciência & Saúde Coletiva•2020

  • Primary care priorities in addressing health equity

    Open Access•Efrat Shadmi, William C W Wong et al.•International Journal for Equity…•2014

  • The contribution of primary care to health and health systems in low- and middle-income countries

    Open Access•Margaret E Kruk, Denis Porignon et al.•Social Science & Medicine•2010

  • Health provider responsiveness to social accountability initiatives in low- and middle-income countries

    Open Access•Elsbet Lodenstein, Marjolein Dieleman et al.•Health Policy and Planning•2017

  • Community accountability at peripheral health facilities

    Open Access•Sassy Molyneux, Martin Atela et al.•Health Policy and Planning•2012

  • Equity in the allocation of public sector financial resources in low- and middle-income countries

    Open Access•Laura Anselmi, Mylene Lagarde et al.•Health Policy and Planning•2015

  • Barriers and Facilitators to Integrating Health Service Responses to Intimate Partner Violence in Low‐ and Middle‐Income Countries

    Open Access•M Colombini, Colleen Dockerty et al.•Studies in Family Planning•2017

  • Psychological assistance during the coronavirus disease 2019 outbreak in China

    Open Access•Yanbo Wang, Xudong Zhao et al.•Journal of Health Psychology•2020

Unique citing works6
Citations per year2
Citation span2023 - 2026 (4)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 5
Ethnos_APP • Open Source Project • MIT License • Frontend v2.0.0 • Privacy and Cookies • API Documentation: api.ethnos.app/docs • API Source Code: GitHub • DOI: 10.5281/zenodo.17049435 • Frontend Source Code: GitHub • DOI: 10.5281/zenodo.17050053 • cruz.rio.br • Expectantes Misericordiae