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Primary Health Care – Challenges and Opportunities for Health Services

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 9053

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Special Issue Editor

Dr. Meera Tandan

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Guest Editor

School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
Interests: antimicrobial resistance and stewardship; chronic disease; primary health care and health service; elderly; drug adverse events; urinary tract infection; respiratory tract infection; COVID-19; medical informatics; public health related issues

Special Issue Information

Dear Colleagues,

Primary health care is the most widely used service in the health system. It refers to the first contact a person has within the health system when they have health issues. These primary health care outlets offer essential health services ranging from health promotion and preventive care to clinical care, including rehabilitation and palliative care. Primary care service delivery differs from country to country. Some offer care via general practitioners and family physicians, while some offer care through primary health centers staffed with allied healthcare professionals such as healthcare assistants, nurses, and including medical doctors. Primary health care outlets and services offered are crucial for developing a sustainable health system and healthy communities. Although world leaders have made commitments to equitable access and quality primary health care services in various international meetings, the primary health care needs of the people are still not fully met. Even basic health care services are out of reach for some communities. Even if they have in place, various geopolitical and human resource issues have made them very difficult to access. In addition, due to a lack of appropriate equipment, training, and favorable environments, health care providers are not able to provide basic healthcare, and quality is another vital issue. Therefore, an in-depth understanding of the challenges and opportunities of health service delivery and utilization in primary care from both provider and consumer perspectives, is necessary to improve the delivery of primary health care services and people's health.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of the knowledge surrounding primary health care services, their challenges, and their opportunities for improvement. Furthermore, this issue encompasses care models that have improved patients' health and safety, including community well-being. We welcome the submission of qualitative and quantitative original research articles, interventions studies, reviews, and case studies related to clinical practice, health promotion, prevention, rehabilitation, and palliative care issues undertaken in primary health care settings.

Dr. Meera Tandan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

primary health care
health service utilisation
equity and access to health services
basic health care
chronic conditions in primary care
infectious disease in primary care
informatics in primary care
medication in primary care
health promotion
epidemiological research

Published Papers (4 papers)

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Research

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16 pages, 363 KiB

Open AccessArticle

“It Is Definitely a Good Program for Everyone from Every Community”: A Qualitative Study of Community Partner Perspectives on the Culturally and Linguistically Diverse (CALD) Mindfulness Program

by Ilse Blignault, Hend Saab, Hanan Youssef, Heba Baddah, Klara Giourgas and Lisa Woodland

Int. J. Environ. Res. Public Health 2023, 20(16), 6608; https://doi.org/10.3390/ijerph20166608 - 18 Aug 2023

Viewed by 1681

Abstract

Meeting the health needs of migrant and refugee communities is crucial to successful settlement and integration. These communities are often under-served by mental health services. Previous research has demonstrated the effectiveness of a group mindfulness-based intervention tailored for Arabic and Bangla speakers living in Sydney, Australia. This study aimed to explore community partner perspectives on the program’s impact, contributing factors and sustainability, and to elicit suggestions for future development. Data were collected via semi-structured telephone interviews with a purposively selected sample of 16 informants. Thematic analysis was conducted using the Rigorous and Accelerated Data Reduction (RADaR) technique. Community partners welcomed the emphasis on promoting wellbeing and reported that the community-based in-language intervention, in both face-to-face and online formats, overcame many of the barriers to timely mental health care for culturally and linguistically diverse (CALD) communities, with a beneficial impact on group participants, program providers, partner organisations and the broader community. Positive outcomes led to stronger community engagement and demand for more programs. For group mental health programs, both trust and safety are necessary. Relationships must be nurtured, diversity within CALD communities recognised, and projects adequately resourced to ensure partner organisations are not overburdened. Full article

(This article belongs to the Special Issue Primary Health Care – Challenges and Opportunities for Health Services)

15 pages, 1242 KiB

Open AccessArticle

Lung Cancer Patients’ Conceptualization of Care Coordination in Selected Public Health Facilities of KwaZulu-Natal, South Africa

by Buhle Lubuzo, Khumbulani W. Hlongwana and Themba G. Ginindza

Int. J. Environ. Res. Public Health 2022, 19(21), 13871; https://doi.org/10.3390/ijerph192113871 - 25 Oct 2022

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Abstract

Background: Cancer patients commonly receive care, including comprehensive treatment options, from multiple specialists within and across facilities offering varying levels of care. Given this multi-layered approach to cancer care, there is a need for coordinated care enhanced through integrated information flow for optimal patient care and improved health outcomes. Objective: This study aimed to explore how patients conceptualized cancer care coordination in an integrated health care system in KwaZulu-Natal. Methods: The study employed a grounded theory design to qualitatively explore the patients’ experiences and views on cancer care coordination using in-depth interviews. Guided by the grounded theory principles, data generation and analysis were conducted iteratively, followed by systematic thematic analysis to organize data, and review and interpret comprehensive findings. This process culminated in the development of themes relating to barriers to cancer care coordination and the interface between the primary and tertiary settings. Theoretical saturation was achieved at 21 in-depth interviews with consenting respondents. Results: This study revealed that care coordination was affected by multilevel challenges, including pertinent health system-level factors, such as difficulty accessing specialty care timeously, weak communication between patients and healthcare providers, and unmet needs concerning supportive care. We found that negative experiences with cancer care erode patient trust and receptiveness to cancer care, and patients advocated for better and proactive coordination amongst different care facilities, services, and providers. Conclusions: An integrated care coordination setup is essential to create and sustain a high-performance health care system. These findings make a case for developing, implementing, and evaluating interventions to enhance the quality of cancer care for patients and ultimately improve health outcomes for patients in KwaZulu-Natal. This study will provide comprehensive data to inform professionals, policymakers, and related decisionmakers to manage and improve cancer care coordination. Full article

(This article belongs to the Special Issue Primary Health Care – Challenges and Opportunities for Health Services)

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Review

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14 pages, 1704 KiB

Open AccessReview

Hepatitis C Infection and Treatment among Injecting Drug Users Attending General Practice: A Systematic Review and Meta-Analysis

by Meera Tandan, Shane Dunlea and Gerard Bury

Int. J. Environ. Res. Public Health 2023, 20(8), 5569; https://doi.org/10.3390/ijerph20085569 - 18 Apr 2023

Viewed by 1521

Abstract

Background: The care provided in general practice to intravenous drug users (IDUs) with hepatitis C (HCV) extends beyond opioid substitution therapy. An aggregated analysis of HCV service utilization within general practice specifically related to diagnosis and treatment outcomes remains unknown from previous literature. Aims: This study aims to estimate the prevalence of HCV and analyze data related to the diagnosis and treatment-related outcomes of HCV patients with a history of intravenous drug use in the general practice setting. Design and setting: A systematic review and meta-analysis in general practice. Methods: This review included studies published in the following databases: EMBASE, PubMed, and Cochrane Central Register of Controlled Trials. Two reviewers independently extracted data in standard forms in Covidence. A meta-analysis was done using a DerSimonian and Laird random-effects model with inverse variance weighting. Results: A total of 20,956 patients from 440 general practices participated in the 18 selected studies. A meta-analysis of 15 studies showed a 46% (95% confidence interval (CI), 26–67%) prevalence rate of hepatitis C amongst IDUs. Genotype information was available in four studies and treatment-related outcomes in 11 studies. Overall, treatment uptake was 9%, with a cure rate of 64% (95% CI, 43–83%). However, relevant information, such as specific treatment regimens, treatment duration and doses, and patient comorbidities, was poorly documented in these studies. Conclusion: The prevalence of HCV in IDUs is 46% in general practice. Only ten studies reported HCV-related treatment outcomes; however, the overall uptake rate was below 10%, with a cure rate of 64%. Likewise, the genotypic variants of HCV diagnoses, medication types, and doses were poorly reported, suggesting a need for further research into this aspect of care within this patient group to ensure optimal treatment outcomes. Full article

(This article belongs to the Special Issue Primary Health Care – Challenges and Opportunities for Health Services)

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14 pages, 981 KiB

Open AccessReview

Clinical Protocols and Treatment Guidelines for the Management of Maternal and Congenital Syphilis in Brazil and Portugal: Analysis and Comparisons: A Narrative Review

by Talita Katiane de Brito Pinto, Aliete Cristina Gomes Dias Pedrosa da Cunha-Oliveira, Ana Isabela Lopes Sales-Moioli, Jane Francinete Dantas, Rosângela Maria Morais da Costa, José Paulo Silva Moura, Sagrario Gómez-Cantarino and Ricardo Alexsandro de Medeiros Valentim

Int. J. Environ. Res. Public Health 2022, 19(17), 10513; https://doi.org/10.3390/ijerph191710513 - 24 Aug 2022

Cited by 8 | Viewed by 2933

Abstract

(1) Background: Maternal syphilis (MS) and congenital syphilis (CS) are serious public health problems worldwide due to their high morbidity and mortality rates. (2) Objective: Evaluating the applicability of Clinical Protocols and Treatment Guidelines on case incidence trends in Brazil and Portugal. (3) Methods: The review was done through bibliographic research in two public databases and government websites from both countries, published between 2007 and 2022. All guidelines that contained CS and MS were selected. (4) Results and discussion: After evaluation, we found that Brazil and Portugal have adequate protocols for screening and treating congenital and maternal syphilis. (5) Conclusion: The results suggest that CS and MS incidence are notably higher in Brazil than in Portugal due to economic, cultural, and social disparities and the differences in territory size. Therefore, these demographic and socioeconomic factors could strongly influence efforts to fight against syphilis and thus control the infection. Full article

(This article belongs to the Special Issue Primary Health Care – Challenges and Opportunities for Health Services)

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