Cargando…

Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda

Health system planners in low- and middle-income countries (LMIC) of the Asia-Pacific region seeking to reorient primary health care (PHC) systems to achieve universal health coverage may be hindered by lack of knowledge of what works in their setting. With limited resources for research available,...

Descripción completa

Detalles Bibliográficos
Autores principales: Palagyi, Anna, Dodd, Rebecca, Jan, Stephen, Nambiar, Devaki, Joshi, Rohina, Tian, Maoyi, Abimbola, Seye, Peiris, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703300/
https://www.ncbi.nlm.nih.gov/pubmed/31478022
http://dx.doi.org/10.1136/bmjgh-2019-001467
_version_ 1783445390622720000
author Palagyi, Anna
Dodd, Rebecca
Jan, Stephen
Nambiar, Devaki
Joshi, Rohina
Tian, Maoyi
Abimbola, Seye
Peiris, David
author_facet Palagyi, Anna
Dodd, Rebecca
Jan, Stephen
Nambiar, Devaki
Joshi, Rohina
Tian, Maoyi
Abimbola, Seye
Peiris, David
author_sort Palagyi, Anna
collection PubMed
description Health system planners in low- and middle-income countries (LMIC) of the Asia-Pacific region seeking to reorient primary health care (PHC) systems to achieve universal health coverage may be hindered by lack of knowledge of what works in their setting. With limited resources for research available, it is important to identify evidence-based strategies for reorganising PHC delivery, determine where relevant evidence gaps exist and prioritise these for future study. This paper describes an approach for doing this using the best available evidence combined with consultation to establish evidence priorities. We first reviewed PHC organisational interventions in Asia-Pacific LMICs and ascertained evidence gaps. The largest gaps related to interventions to promote access to essential medicines, patient management tools, effective health promotion strategies and service planning and accountability. Evidence from Pacific Island countries was particularly scant. We then engaged an expert panel of 22 PHC stakeholders from seven Asia-Pacific LMICs in a Delphi exercise to identify priority questions for future research. Research priorities were: (1) identifying effective PHC service delivery models for chronic diseases; (2) devising sustainable models of disease integration; (3) optimising task shifting; (4) understanding barriers to care continuity; (5) projecting future PHC needs; and (6) designing appropriate PHC service packages. Notably, stakeholder-determined priorities reflected large, context-dependent system issues, while evidence gaps centred on discrete interventions. Future research on the organisation of PHC services in Asia-Pacific LMICs should incorporate codesign principles to engage researchers and national PHC system stakeholders, and innovative methods that build on existing evidence and account for system complexity.
format Online
Article
Text
id pubmed-6703300
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-67033002019-09-02 Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda Palagyi, Anna Dodd, Rebecca Jan, Stephen Nambiar, Devaki Joshi, Rohina Tian, Maoyi Abimbola, Seye Peiris, David BMJ Glob Health Analysis Health system planners in low- and middle-income countries (LMIC) of the Asia-Pacific region seeking to reorient primary health care (PHC) systems to achieve universal health coverage may be hindered by lack of knowledge of what works in their setting. With limited resources for research available, it is important to identify evidence-based strategies for reorganising PHC delivery, determine where relevant evidence gaps exist and prioritise these for future study. This paper describes an approach for doing this using the best available evidence combined with consultation to establish evidence priorities. We first reviewed PHC organisational interventions in Asia-Pacific LMICs and ascertained evidence gaps. The largest gaps related to interventions to promote access to essential medicines, patient management tools, effective health promotion strategies and service planning and accountability. Evidence from Pacific Island countries was particularly scant. We then engaged an expert panel of 22 PHC stakeholders from seven Asia-Pacific LMICs in a Delphi exercise to identify priority questions for future research. Research priorities were: (1) identifying effective PHC service delivery models for chronic diseases; (2) devising sustainable models of disease integration; (3) optimising task shifting; (4) understanding barriers to care continuity; (5) projecting future PHC needs; and (6) designing appropriate PHC service packages. Notably, stakeholder-determined priorities reflected large, context-dependent system issues, while evidence gaps centred on discrete interventions. Future research on the organisation of PHC services in Asia-Pacific LMICs should incorporate codesign principles to engage researchers and national PHC system stakeholders, and innovative methods that build on existing evidence and account for system complexity. BMJ Publishing Group 2019-08-16 /pmc/articles/PMC6703300/ /pubmed/31478022 http://dx.doi.org/10.1136/bmjgh-2019-001467 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Analysis
Palagyi, Anna
Dodd, Rebecca
Jan, Stephen
Nambiar, Devaki
Joshi, Rohina
Tian, Maoyi
Abimbola, Seye
Peiris, David
Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title_full Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title_fullStr Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title_full_unstemmed Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title_short Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda
title_sort organisation of primary health care in the asia-pacific region: developing a prioritised research agenda
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703300/
https://www.ncbi.nlm.nih.gov/pubmed/31478022
http://dx.doi.org/10.1136/bmjgh-2019-001467
work_keys_str_mv AT palagyianna organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT doddrebecca organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT janstephen organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT nambiardevaki organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT joshirohina organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT tianmaoyi organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT abimbolaseye organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda
AT peirisdavid organisationofprimaryhealthcareintheasiapacificregiondevelopingaprioritisedresearchagenda