Below are the citation and extracts of a Comment in The Lancet Global Health, referring to two research papers, and a comment from me.
CITATION: Improving primary health-care services in LMIC cities
Richard J Lilford et al. Lancet Global Health Volume 13, Issue 5e795-e79
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00537-0/fulltext
'The first paper in this Series of two describes the configuration, cost, and quality of primary-care services in LMIC cities, along with the preferences of service users for different types of service... the average quality of services is generally poor; many clinicians fail to make the correct diagnosis or implement the appropriate treatment,3 long-term conditions are poorly managed,5 antibiotic stewardship is inadequate,6 and medicine stockouts are frequent.
'The second paper discusses the implications of these findings for policy aimed at the improvement of primary health services in these cities. The presence of primary health-care markets provides an opportunity to reshape the market through policies that change the mix of available providers... One of the best ways to invest in improving existing services is through the formation of muti-disciplinary primary care teams integrating facility care (provided by doctors and nurses) with community care (provided by community health workers)...'
COMMENT (NPW): Often when we talk of primary health care we think of rural health care, and this paper is an important reminder of the importance of primary care in urban areas. The health system differs, with greater access but apparently poor quality of services. It would be interesting to understand the factors contributing to low quality of care in urban PHC (as compared with rural PHC). The ability to access and apply reliable healthcare information is likely to be a major factor. Are HIFA members aware of health information initiatives that are serving different types of primary care provider in urban settings?
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org