Primary Health Care Implementation in Asia: A systematic review

ABSTRACT

Background@#Primary health care (PHC) is a central feature of the UHC. Across Asia, health system planners seeking to strengthen PHC systems may be hindered by several factors, including lack of knowledge of what works in the setting. Pressures placed on health care systems of Asian nations caused by epidemiological changes, including COVID-19 pandemic, and other health issues, are amplified by the demands of population seeking for high-quality care.@*Objective@#To determine the implementation of primary health care across the Asian region @*Methods@#This review utilized 9 online databases, based on the Preferred Reporting Items for Systematic Review Guidelines. Inclusion criteria were studies evaluating the policy implementation of PHC in Asia, published from 2002-2022, accessible online in full-text, English or translation, published in peer-reviewed journals. Three reviewers independently evaluated the abstracts, extracted the data, and assessed the quality of the included studies based on the Critical Appraisal Skills Programme checklist. Descriptive synthesis was undertaken to summarize and report the study findings. @*Results@#Sixteen studies met the inclusion criteria out of 815 search results. Four indicators were included governance, financing, health workforce, and medicines and other health products showed both positive and negative results. However, recurring challenges are still prevalent in the implementation of PHC, especially in health service delivery. Enabling factors for effective implementation of PHC were community behavioral change, committed political will, increased health coverage and free access, health workforce performance and evaluation among others. Barriers included were economic shocks, corruption, preventive health inequalities and inequities, resource misallocation, and health insurance status among others. @*Conclusion@#Much has already been done in PHC implementation within Asia. However, greater efforts are still needed to implement PHC efficiently in the areas of governance, financing, health workforce, and medicines and other health products. Enablers should be modeled, while barriers should be overcome.