Adesuyi Emmanuel O, Olabode Opeoluwa O, Olarinde Oluwatosin C, Oyama Blessed O, Aderemi Inioluwa O, Alao Gloria O, Ogunlowo Bose C
College of Health and Care Professions Birmingham City University Birmingham West Midlands UK.
Institute of Nursing Research Osogbo Nigeria.
Public Health Chall. 2025 Jul 18;4(3):e70081. doi: 10.1002/puh2.70081. eCollection 2025 Sep.
The primary health centres are designed to be the first line of contact with the public and the main target for achieving universal health coverage (UHC). However, despite global advancements in healthcare, Africa continues to face unacceptably high health outcome indices, underscoring the significant challenges in achieving UHC. This review synthesises evidence on the factors influencing the primary healthcare system, focusing on its role in achieving UHC within the WHO-Afro region.
This is an integrative literature review. An extensive and systematic search for eligible literature was performed in eight databases between 2000 and 2024, including APA PsycINFO, CINAHL, Medline, Scopus, EmCare, Embase, Ovid Nursing and Gale Academic One File. The articles identified were critically appraised. A narrative synthesis of evidence was done to fully explore the review question. The findings were presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in-line with EQUATOR guidelines.
Overall, 26 studies were included in the review. Six themes captured the factors influencing the PHC system in the achievement of UHC: (1) physical access to critical services, (2) availability of resources, (3) sociodemographic and cultural factors, (4) access to data and health information, (5) legislation and policy and (6) quality of care.
This review highlights interconnected factors necessitating a holistic approach to optimising PHC effectiveness and driving progress towards achieving UHC. Integrating human, financial and infrastructural resources alongside community-driven strategies, equitable digital technologies and robust policy frameworks is essential to improving health outcomes and achieving UHC.
初级卫生保健中心旨在成为与公众的第一线接触点，也是实现全民健康覆盖（UHC）的主要目标。然而，尽管全球医疗保健取得了进步，但非洲的健康结果指标仍然高得令人无法接受，这凸显了在实现全民健康覆盖方面的重大挑战。本综述综合了关于影响初级卫生保健系统的因素的证据，重点关注其在世界卫生组织非洲区域实现全民健康覆盖中的作用。
这是一项综合文献综述。在2000年至2024年期间，对八个数据库进行了广泛而系统的合格文献搜索，包括美国心理学会心理学文摘数据库（APA PsycINFO）、护理学与健康领域数据库（CINAHL）、医学期刊数据库（Medline）、Scopus数据库、循证医学数据库（EmCare）、荷兰医学文摘数据库（Embase）、Ovid护理学数据库和Gale学术大全数据库。对筛选出的文章进行了严格评估。对证据进行了叙述性综合，以充分探讨综述问题。研究结果按照系统评价和Meta分析的首选报告项目（PRISMA）并遵循赤道准则进行呈现。
总体而言，本综述纳入了26项研究。六个主题涵盖了影响初级卫生保健系统实现全民健康覆盖的因素：（1）关键服务的实际可及性；（2）资源可用性；（3）社会人口和文化因素；（4）数据和健康信息的获取；（5）立法与政策；（6）医疗质量。
本综述强调了相互关联的因素，需要采取整体方法来优化初级卫生保健的有效性，并推动在实现全民健康覆盖方面取得进展。整合人力、财力和基础设施资源，同时结合社区驱动的战略、公平的数字技术和强大的政策框架，对于改善健康结果和实现全民健康覆盖至关重要。
