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强化 COVID-19 大流行期间初级卫生保健弹性的策略:范围综述。

Strategies to strengthen the resilience of primary health care in the COVID-19 pandemic: a scoping review.

机构信息

Health policy and management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran.

Health policy, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.

出版信息

BMC Health Serv Res. 2024 Jul 25;24(1):841. doi: 10.1186/s12913-024-11278-4.


DOI:10.1186/s12913-024-11278-4
PMID:39054502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11270795/
Abstract

BACKGROUND: Primary Health Care (PHC) systems are pivotal in delivering essential health services during crises, as demonstrated during the COVID-19 pandemic. With varied global strategies to reinforce PHC systems, this scoping review consolidates these efforts, identifying and categorizing key resilience-building strategies. METHODS: Adopting Arksey and O'Malley's scoping review framework, this study synthesized literature across five databases and Google Scholar, encompassing studies up to December 31st, 2022. We focused on English and Persian studies that addressed interventions to strengthen PHC amidst COVID-19. Data were analyzed through thematic framework analysis employing MAXQDA 10 software. RESULTS: Our review encapsulated 167 studies from 48 countries, revealing 194 interventions to strengthen PHC resilience, categorized into governance and leadership, financing, workforce, infrastructures, information systems, and service delivery. Notable strategies included telemedicine, workforce training, psychological support, and enhanced health information systems. The diversity of the interventions reflects a robust global response, emphasizing the adaptability of strategies across different health systems. CONCLUSIONS: The study underscored the need for well-resourced, managed, and adaptable PHC systems, capable of maintaining continuity in health services during emergencies. The identified interventions suggested a roadmap for integrating resilience into PHC, essential for global health security. This collective knowledge offered a strategic framework to enhance PHC systems' readiness for future health challenges, contributing to the overall sustainability and effectiveness of global health systems.

摘要

背景:初级卫生保健 (PHC) 系统在危机期间提供基本卫生服务方面发挥着关键作用,这在 COVID-19 大流行期间得到了证明。随着各种强化 PHC 系统的全球战略,本范围综述整合了这些努力,确定并分类了关键的弹性建设策略。

方法:采用 Arksey 和 O'Malley 的范围综述框架,本研究综合了五个数据库和 Google Scholar 上的文献,涵盖了截至 2022 年 12 月 31 日的研究。我们专注于解决在 COVID-19 期间加强 PHC 的英语和波斯语研究。通过 MAXQDA 10 软件采用主题框架分析对数据进行分析。

结果:我们的综述涵盖了来自 48 个国家的 167 项研究,揭示了 194 项加强 PHC 弹性的干预措施,分为治理和领导、融资、劳动力、基础设施、信息系统和服务提供。值得注意的策略包括远程医疗、劳动力培训、心理支持和加强卫生信息系统。干预措施的多样性反映了全球的积极应对,强调了策略在不同卫生系统中的适应性。

结论:该研究强调了需要资源充足、管理良好且适应性强的 PHC 系统,以在紧急情况下保持卫生服务的连续性。确定的干预措施为将弹性纳入 PHC 提供了路线图,这对于全球卫生安全至关重要。这一集体知识提供了一个加强 PHC 系统应对未来健康挑战的战略框架,有助于提高全球卫生系统的整体可持续性和效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/93d07d46a6ef/12913_2024_11278_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/213799f062c1/12913_2024_11278_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/c6a61312fdf0/12913_2024_11278_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/4b8aa4c75a79/12913_2024_11278_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/93d07d46a6ef/12913_2024_11278_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/213799f062c1/12913_2024_11278_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/c6a61312fdf0/12913_2024_11278_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/4b8aa4c75a79/12913_2024_11278_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fea5/11270795/93d07d46a6ef/12913_2024_11278_Fig4_HTML.jpg

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引用本文的文献

[1]
The Impact of Polycrisis on Healthcare Systems-Analyzing Challenges and the Role of Social Epidemiology.

Healthcare (Basel). 2025-8-14

[2]
Resilience Informatics in Public Health: Qualitative Analysis of Conference Proceedings.

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本文引用的文献

[1]
Resilience of primary healthcare system across low- and middle-income countries during COVID-19 pandemic: a scoping review.

Health Res Policy Syst. 2023-9-18

[2]
Strategies to strengthen a climate-resilient health system: a scoping review.

Global Health. 2023-8-28

[3]
Health System Governance Evaluation: A Scoping Review.

Iran J Public Health. 2023-2

[4]
Resiliency of the Iranian healthcare facilities against the Covid-19 pandemic: challenges and solutions.

BMC Health Serv Res. 2023-3-1

[5]
A systematic scoping review of digital health technologies during COVID-19: a new normal in primary health care delivery.

Health Technol (Berl). 2023

[6]
Sustainable financing for Immunization Agenda 2030.

Vaccine. 2024-4-8

[7]
Extending health systems resilience into communities: a qualitative study with community-based actors providing health services during the COVID-19 pandemic in the Philippines.

BMC Health Serv Res. 2022-11-21

[8]
MIDO COVID: A digital public health strategy designed to tackle chronic disease and the COVID-19 pandemic in Mexico.

PLoS One. 2022

[9]
Retrospective study of COVID-19 outcomes among healthcare workers in Rivers State, Nigeria.

BMJ Open. 2022-11-11

[10]
Primary Health Care System Strengthening Project in Sri Lanka: Status and Challenges with Human Resources, Information Systems, Drugs and Laboratory Services.

Healthcare (Basel). 2022-11-10

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