Integrating primary health services in low‐ and middle‐income countries
Citation: Dudley L, Garner P. Strategies for integrating primary health services in low‐ and middle‐income countries at the point of delivery. Cochrane Database of Systematic Reviews 2011;(7):CD003318
What is this? The COVID-19 pandemic is placing a strain on healthcare systems. Existing research on strategies to increase efficiency and access, such as the integration of different primary healthcare services, might provide useful information for policy makers.
In this Cochrane systematic review, the authors searched for comparative effectiveness studies of the effects of the integration of primary healthcare services in low- and middle-income countries. They did not restrict their searches by date or language of publication and did the search in September 2010. They included 5 randomized trials and 4 controlled before-and-after studies. The studies assessed adding an additional specialized service (e.g. family planning or HIV counselling and testing) to existing routine services (5 studies) or the comparison of an integrated program of services versus a single, specialized service (4).
What was found: The addition of a specialized component to existing services probably increases service use but without affecting patient outcomes.
Integrating specialized services may decrease service use, client knowledge and satisfaction with services, without affecting health outcomes, compared to a specialized service.
The economic impacts, and patients’ views, preferences and experiences, of integrating primary care services are uncertain.
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