Saif-Ur-Rahman K M, Sultana Saima, Afrin Sadia, Islam Khaleda
Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
Projahnmo Research Foundation, Dhaka, Bangladesh.
Public Health Pract (Oxf). 2022 Nov 23;4:100344. doi: 10.1016/j.puhip.2022.100344. eCollection 2022 Dec.
Primary Health Care (PHC) oriented health systems are crucial to accelerate the achievement of Universal Health Coverage. Previous studies have suggested the importance of participatory approaches to improve PHC. This review aimed to identify the available published implementation research in PHC considering participatory approaches in Low and Middle-Income Countries (LMICs).
A narrative review was conducted following the standard guidelines.
Three electronic databases were searched where keywords were combined using Boolean operators. Studies were included considering the pre-specified inclusion and exclusion criteria through two-phase screening. The quality of the included studies was assessed using the Joanna Briggs Institution's critical appraisal tools. Data were presented using a narrative synthesis approach.
A total of 13 articles were included that focused on community-based approaches in PHC service, maternal and newborn care, family planning, tuberculosis, and mental health. Three studies focused on mental health and demonstrated the efficacy of community support groups, peer volunteers, and community-based mental education in promoting mental health services. Two studies described community participation to ensure patient safety and risk reduction. Other studies explored the effectiveness of community-based, directly observed treatment for tuberculosis; community health worker-based maternal and child health care; and a community-based package for family planning. Eleven studies were conducted in Africa and the rest were in South Asia.
This review reveals the gap in implementation research incorporating participatory approaches in the field of PHC. Limited studies have been conducted which indicate the need and scope of implementation research with participatory approaches in the PHC field.
CRD42020150749.
以初级卫生保健（PHC）为导向的卫生系统对于加速实现全民健康覆盖至关重要。先前的研究表明参与式方法对于改善初级卫生保健的重要性。本综述旨在确定在低收入和中等收入国家（LMICs）的初级卫生保健中考虑参与式方法的已发表实施研究。
按照标准指南进行叙述性综述。
搜索了三个电子数据库，使用布尔运算符组合关键词。通过两阶段筛选，根据预先指定的纳入和排除标准纳入研究。使用乔安娜·布里格斯研究所的批判性评估工具评估纳入研究的质量。采用叙述性综合方法呈现数据。
共纳入13篇文章，这些文章聚焦于初级卫生保健服务、孕产妇和新生儿护理、计划生育、结核病及心理健康方面的社区方法。三项研究聚焦于心理健康，证明了社区支持小组、同伴志愿者和社区心理健康教育在促进心理健康服务方面的功效。两项研究描述了社区参与以确保患者安全和降低风险。其他研究探讨了基于社区的直接观察结核病治疗、基于社区卫生工作者的母婴保健以及基于社区的计划生育套餐的有效性。11项研究在非洲进行，其余在南亚。
本综述揭示了在初级卫生保健领域纳入参与式方法的实施研究方面的差距。已开展的研究有限，这表明在初级卫生保健领域采用参与式方法进行实施研究的必要性和范围。
PROSPERO注册编号：CRD42020150749。
