Evaluating primary care networks in low-income and lower middle-income countries

A scoping review

Bibliographic Data

ID21879387
AuthorsAdwoa Agyemang-Benneh (0000-0003-4524-364X, Manchester Academic Health Science Centre, corresponding author), Igor Francetic (0000-0002-2481-3749, Manchester Academic Health Science Centre), J Hammond (0000-0002-4682-9514, Manchester Academic Health Science Centre), Kath Checkland (0000-0002-9961-5317, Manchester Academic Health Science Centre), Katherine Checkland (Division of Population Health, Health Services Research and Primary Care, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK)
Year2023
Volume8
Issue8
Pagese012505
Publication date2023-08-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-012505
PMID37580101
OpenAlexW4385813976
LanguageEN
Citations received3
References cited37

INTRODUCTION: Primary care networks (PCNs) are claimed to be an effective model to organise and deliver primary healthcare through collaborative relationships and effective coordination of primary care activities. Though increasingly implemented in different contexts, there is limited evidence on the effectiveness of PCNs in low-income and lower middle-income countries (LLMICs). OBJECTIVE: Our scoping review aims to understand how PCNs in LLMICs have been conceptualised, implemented and analysed in the literature and further explores the evidence of the effectiveness of these networks. METHODS: . We also used the population, concept and context (PCC) guide of the Joanna Briggs Institute (JBI) methodology for scoping reviews to define the search strategy. The identified documents were then mapped, using Cunningham's evaluation framework for health networks, to understand how PCNs are conceived in LLMIC settings. RESULTS: We identified 20 documents describing PCNs in five LLMICs. The selected documents showed differing forms and complexities of networks, with a majority resourced by government, non-governmental and donor entities. Most networks were mandated, and established with defined goals, although these were not always understood by stakeholders. Unlike PCNs in developed settings, the scoping review did not identify integration of care as a major goal for the establishment of PCNs in LLMICs. Network evaluation relationships, outputs and outcomes also varied across the five networks in the identified documents, and perceptions of effectiveness differed across stakeholder groups. CONCLUSION: PCNs in LLMICs benefit from clearly stated goals and measurable outcomes, which facilitates evaluation. In order to maximise the benefits, careful attention to the aspects of network design and operation is required. Future research work could shed light on some of the missing pieces of evidence on their effectiveness by, for example, considering differential consequences of modes of network establishment and operation, including unintended consequences in the systems within which they reside, and evaluating long-term implications

Geography · Health care · Political science · Public relations · Stakeholder · Global Maternal and Child Health · Interprofessional Education and Collaboration · Primary Care and Health Outcomes · Psychology