People-centred primary health care: a scoping review

Resham B Khatri; Eskinder Wolka; Frehiwot Nigatu; Anteneh Zewdie; Daniel Erku; Aklilu Endalamaw; Yibeltal Assefa

doi:10.1186/s12875-023-02194-3

People-centred primary health care: a scoping review

BMC Prim Care. 2023 Nov 9;24(1):236. doi: 10.1186/s12875-023-02194-3.

Authors

Resham B Khatri^{1

2}, Eskinder Wolka³, Frehiwot Nigatu³, Anteneh Zewdie³, Daniel Erku^{4

5}, Aklilu Endalamaw^{6

7}, Yibeltal Assefa⁶

Affiliations

¹ School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia. rkchettri@gmail.com.
² Health Social Science and Development Research Institute, Kathmandu, Nepal. rkchettri@gmail.com.
³ International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia.
⁴ Centre for Applied Health Economics, School of Medicine, Griffith University, Southport, QLD, Australia.
⁵ Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
⁶ School of Public Health, Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia.
⁷ College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Abstract

Background: Integrated people-centred health services (IPCHS) are vital for ensuring comprehensive care towards achieving universal health coverage (UHC). The World Health Organisation (WHO) envisions IPCHS in delivery and access to health services. This scoping review aimed to synthesize available evidence on people-centred primary health care (PHC) and primary care.

Methods: We conducted a scoping review of published literature on people-centred PHC. We searched eight databases (PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, Web of Science, and Google Scholar) using search terms related to people-centred and integrated PHC/primary care services. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to select studies. We analyzed data and generated themes using Gale's framework thematic analysis method. Themes were explained under five components of the WHO IPCHS framework.

Results: A total of fifty-two studies were included in the review; most were from high-income countries (HICs), primarily focusing on patient-centred primary care. Themes under each component of the framework included: engaging and empowering people and communities (engagement of community, empowerment and empathy); strengthening governance and accountability (organizational leadership, and mutual accountability); reorienting the model of care (residential care, care for multimorbidity, participatory care); coordinating services within and across sectors (partnership with stakeholders and sectors, and coordination of care); creating an enabling environment and funding support (flexible management for change; and enabling environment).

Conclusions: Several people-centred PHC and primary care approaches are implemented in HICs but have little priority in low-income countries. Potential strategies for people-centred PHC could be engaging end users in delivering integrated care, ensuring accountability, and implementing a residential model of care in coordination with communities. Flexible management options could create an enabling environment for strengthening health systems to deliver people-centred PHC services.

Keywords: Integrated care; People-centred care; Primary care; Primary health care.

Publication types

Systematic Review
Review

MeSH terms

Government Programs
Health Services*
Humans
Income
Patient-Centered Care* / methods
Population Groups