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Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana
BACKGROUND: Primary healthcare (PHC) is a core part of healthcare in developing countries. However, the implementation of PHC since its inception in developing countries has been lethargic, inconsistent and marred by controversies. AIM: This study investigates some of the controversies surrounding P...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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AOSIS
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284167/ https://www.ncbi.nlm.nih.gov/pubmed/32501025 http://dx.doi.org/10.4102/phcfm.v12i1.2183 |
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author | Appiah-Agyekum, Nana Nimo |
author_facet | Appiah-Agyekum, Nana Nimo |
author_sort | Appiah-Agyekum, Nana Nimo |
collection | PubMed |
description | BACKGROUND: Primary healthcare (PHC) is a core part of healthcare in developing countries. However, the implementation of PHC since its inception in developing countries has been lethargic, inconsistent and marred by controversies. AIM: This study investigates some of the controversies surrounding PHC implementation. It also examines how PHC is being implemented in Ghana as well as how the approaches adopted by PHC implementers influence PHC outcomes in developing countries. SETTING: This study is set in Ghana and involves national, regional and district managers of PHC. METHODS: A qualitative case study was used to gather information from 19 frontline PHC managers through semi-structured interviews. Interviews were recorded and transcribed. They were then qualitatively analysed using the thematic framework analyses approach. RESULTS: Findings uncover a lack of clear meaning of what PHC is and how it should be approached amongst key implementers. It also shows discrepancies between official policy documents and directives, and actual PHC practices. Findings also show a gradual shift from Alma Ata’s comprehensive PHC towards a more selective and intervention-specific PHC. Whilst donor and external stakeholders’ influence are the key determinants of PHC policy implementation, their support for vertical and other medicine-based interventions have gradually medicalised PHC. CONCLUSION: There is a need to pay more attention to understanding and addressing the gaps in PHC implementation and its inconsistencies. Furthermore, the role and control of donors and external development partners in PHC policy formulation and implementation, and their concomitant effects on community participation and empowerment, must be critically examined. |
format | Online Article Text |
id | pubmed-7284167 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AOSIS |
record_format | MEDLINE/PubMed |
spelling | pubmed-72841672020-06-15 Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana Appiah-Agyekum, Nana Nimo Afr J Prim Health Care Fam Med Original Research BACKGROUND: Primary healthcare (PHC) is a core part of healthcare in developing countries. However, the implementation of PHC since its inception in developing countries has been lethargic, inconsistent and marred by controversies. AIM: This study investigates some of the controversies surrounding PHC implementation. It also examines how PHC is being implemented in Ghana as well as how the approaches adopted by PHC implementers influence PHC outcomes in developing countries. SETTING: This study is set in Ghana and involves national, regional and district managers of PHC. METHODS: A qualitative case study was used to gather information from 19 frontline PHC managers through semi-structured interviews. Interviews were recorded and transcribed. They were then qualitatively analysed using the thematic framework analyses approach. RESULTS: Findings uncover a lack of clear meaning of what PHC is and how it should be approached amongst key implementers. It also shows discrepancies between official policy documents and directives, and actual PHC practices. Findings also show a gradual shift from Alma Ata’s comprehensive PHC towards a more selective and intervention-specific PHC. Whilst donor and external stakeholders’ influence are the key determinants of PHC policy implementation, their support for vertical and other medicine-based interventions have gradually medicalised PHC. CONCLUSION: There is a need to pay more attention to understanding and addressing the gaps in PHC implementation and its inconsistencies. Furthermore, the role and control of donors and external development partners in PHC policy formulation and implementation, and their concomitant effects on community participation and empowerment, must be critically examined. AOSIS 2020-05-20 /pmc/articles/PMC7284167/ /pubmed/32501025 http://dx.doi.org/10.4102/phcfm.v12i1.2183 Text en © 2020. The Authors https://creativecommons.org/licenses/by/4.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. |
spellingShingle | Original Research Appiah-Agyekum, Nana Nimo Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title | Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title_full | Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title_fullStr | Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title_full_unstemmed | Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title_short | Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana |
title_sort | primary healthcare implementation in practice: evidence from primary healthcare managers in ghana |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284167/ https://www.ncbi.nlm.nih.gov/pubmed/32501025 http://dx.doi.org/10.4102/phcfm.v12i1.2183 |
work_keys_str_mv | AT appiahagyekumnananimo primaryhealthcareimplementationinpracticeevidencefromprimaryhealthcaremanagersinghana |