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

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Show simple item record Goodyear-Smith, Felicity en Bazemore, Andrew en Coffman, Megan en Fortier, Richard DW en Howe, Amanda en Kidd, Michael en Phillips, Robert en Rouleau, Katherine en van Weel, Chris en 2020-04-03T02:55:40Z en 2019-01 en
dc.identifier.citation BMJ global health 4(Suppl 8):e001482 Jan 2019 en
dc.identifier.issn 2059-7908 en
dc.identifier.uri en
dc.description.abstract 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 middle-income 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 policy-makers 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. en
dc.format.medium Electronic-eCollection en
dc.language eng en
dc.relation.ispartofseries BMJ global health en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.rights.uri en
dc.title Research gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: a mixed-methods approach. en
dc.type Journal Article en
dc.identifier.doi 10.1136/bmjgh-2019-001482 en
pubs.issue Suppl 8 en
pubs.begin-page e001482 en
pubs.volume 4 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 789133 en Medical and Health Sciences en Population Health en Gen.Practice& Primary Hlthcare en
dc.identifier.eissn 2059-7908 en
pubs.record-created-at-source-date 2019-09-10 en
pubs.dimensions-id 31497316 en

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