Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.
Int J Equity Health. 2023 Aug 31;22(1):171. doi: 10.1186/s12939-023-01968-6.
The COVID-19 pandemic substantially magnified the inequity gaps among vulnerable populations. Both public health (PH) and primary health care (PHC) have been crucial in addressing the challenges posed by the pandemic, especially in the area of vulnerable populations. However, little is known about the intersection between PH and PHC as a strategy to mitigate the inequity gap. This study aims to assess the collaboration between PHC and PH with a focus on addressing the health needs of vulnerable populations during the COVID-19 pandemic across jurisdictions.
We analyzed and compared data from jurisdictional reports of COVID-19 pandemic responses in PHC and PH in Belgium, Canada (Ontario), Germany, Italy, Japan, the Netherlands, Norway, and Spain from 2020 to 2021.
Four themes emerge from the analysis: (1) the majority of the countries implemented outreach strategies targeting vulnerable groups as a means to ensure continued access to PHC; (2) digital assessment in PHC was found to be present across all the countries; (3) PHC was insufficiently represented at the decision-making level; (4) there is a lack of clear communication channels between PH and PHC in all the countries.
This study identified opportunities for collaboration between PHC and PH to reduce inequity gaps and to improve population health, focusing on vulnerable populations. The COVID-19 response in these eight countries has demonstrated the importance of an integrated PHC system. Consequently, the development of effective strategies for responding to and planning for pandemics should take into account the social determinants of health in order to mitigate the unequal impact of COVID-19. Careful, intentional coordination between PH and PHC should be established in normal times as a basis for effective response during future public health emergencies. The pandemic has provided significant insights on how to strengthen health systems and provide universal access to healthcare by fostering stronger connections between PH and PHC.
COVID-19 大流行极大地扩大了弱势群体之间的不平等差距。公共卫生（PH）和初级卫生保健（PHC）在应对大流行带来的挑战方面都至关重要，尤其是在弱势群体方面。然而，人们对 PH 和 PHC 作为减轻不平等差距的策略之间的交集知之甚少。本研究旨在评估 PHC 和 PH 之间的合作，重点是在 COVID-19 大流行期间解决各司法管辖区弱势群体的健康需求。
我们分析和比较了 2020 年至 2021 年期间比利时、加拿大（安大略省）、德国、意大利、日本、荷兰、挪威和西班牙的 PHC 和 PH 应对 COVID-19 大流行的司法管辖区报告中的数据。
从分析中得出了四个主题：（1）大多数国家实施了针对弱势群体的外展战略，以确保他们继续获得 PHC；（2）在所有国家都发现了 PHC 中的数字评估；（3）PHC 在决策层面的代表性不足；（4）在所有国家中，PH 和 PHC 之间缺乏明确的沟通渠道。
本研究确定了 PHC 和 PH 之间合作的机会，以缩小不平等差距，改善人口健康，重点关注弱势群体。这八个国家对 COVID-19 的反应表明了整合 PHC 系统的重要性。因此，制定有效的应对和规划大流行的策略应考虑健康的社会决定因素，以减轻 COVID-19 的不平等影响。在正常时期，应在 PH 和 PHC 之间建立精心、有意识的协调，作为未来公共卫生紧急情况下有效应对的基础。大流行提供了重要的见解，说明如何通过加强 PH 和 PHC 之间的联系来加强卫生系统并为所有人提供医疗保健。
