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Research gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: a mixed-methods approach

Goodyear-Smith, Felicity; Bazemore, Andrew; Coffman, Megan; Fortier, Richard; Howe, Amanda; Kidd, Michael; Phillips, Robert L.; Rouleau, Katherine; van Weel, Chris

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Introduction Since the Alma-Ata Declaration 40 years ago, primary healthcare (PHC) has made great advances, but there is insufficient research on models of care and outcomes-particularly for low-income and middleincome countries (LMICs). Systematic efforts to identify these gaps and develop evidence-based strategies for improvement in LMICs has been lacking. We report on a global effort to identify and prioritise the knowledge needs of PHC practitioners and researchers in LMICs about...[Show more]

dc.contributor.authorGoodyear-Smith, Felicity
dc.contributor.authorBazemore, Andrew
dc.contributor.authorCoffman, Megan
dc.contributor.authorFortier, Richard
dc.contributor.authorHowe, Amanda
dc.contributor.authorKidd, Michael
dc.contributor.authorPhillips, Robert L.
dc.contributor.authorRouleau, Katherine
dc.contributor.authorvan Weel, Chris
dc.date.accessioned2020-12-04T01:57:21Z
dc.date.available2020-12-04T01:57:21Z
dc.identifier.issn2059-7908
dc.identifier.urihttp://hdl.handle.net/1885/216694
dc.description.abstractIntroduction Since the Alma-Ata Declaration 40 years ago, primary healthcare (PHC) has made great advances, but there is insufficient research on models of care and outcomes-particularly for low-income and middleincome countries (LMICs). Systematic efforts to identify these gaps and develop evidence-based strategies for improvement in LMICs has been lacking. We report on a global effort to identify and prioritise the knowledge needs of PHC practitioners and researchers in LMICs about PHC organisation. Methods Three-round modified Delphi using web-based surveys. PHC practitioners and academics and policymakers from LMICs sampled from global networks. First round (pre-Delphi survey) collated possible research questions to address knowledge gaps about organisation. Responses were independently coded, collapsed and synthesised. Round 2 (Delphi round 1) invited panellists to rate importance of each question. In round 3 (Delphi round 2), panellists ranked questions into final order of importance. Literature review conducted on 36 questions and gap map generated. Results Diverse range of practitioners and academics in LMICs from all global regions generated 744 questions for PHC organisation. In round 2, 36 synthesised questions on organisation were rated. In round 3, the top 16 questions were ranked to yield four prioritised questions in each area. Literature reviews confirmed gap in evidence on prioritised questions in LMICs. Conclusion In line with the 2018 Astana Declaration, this mixed-methods study has produced a unique list of essential gaps in our knowledge of how best to organise PHC, priority-ordered by LMIC expert informants capable of shaping their mitigation. Research teams in LMIC have developed implementation plans to answer the top four ranked research questions.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBMJ Publishing Group
dc.rights© Author(s) (or their employer(s)) 2019
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.sourceBMJ Global Health
dc.titleResearch gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: a mixed-methods approach
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume4
dc.date.issued2019
local.identifier.absfor111717 - Primary Health Care
local.identifier.ariespublicationu5786633xPUB1715
local.publisher.urlhttp://gh.bmj.com/
local.type.statusPublished Version
local.contributor.affiliationGoodyear-Smith, Felicity, University of Auckland
local.contributor.affiliationBazemore, Andrew, Robert Graham Center
local.contributor.affiliationCoffman, Megan, Robert Graham Center Policy Studies in Family Medicine & Primary Care
local.contributor.affiliationFortier, Richard, University of Auckland
local.contributor.affiliationHowe, Amanda, University of East Anglia
local.contributor.affiliationKidd, Michael, University of Toronto
local.contributor.affiliationPhillips, Robert L., American Board of Family Medicine
local.contributor.affiliationRouleau, Katherine, University of Toronto
local.contributor.affiliationVan Weel, Chris, College of Health and Medicine, ANU
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage11
local.identifier.doi10.1136/bmjgh-2019-001482
local.identifier.absseo920204 - Evaluation of Health Outcomes
dc.date.updated2020-07-19T08:31:17Z
local.identifier.thomsonIDWOS:000500407900007
dcterms.accessRightsOpen Access
dc.provenanceThis is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.rights.licenseCreative Commons Attribution Non Commercial (CC BY-NC 4.0) license
CollectionsANU Research Publications

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