The roles and challenges of the primary health care systems in epidemic management: a scoping review.

Elham Shami, Kamal Gholipour, Deniz Naghibi, Saber Azami-Aghdash
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Abstract

Background and aim: During the early stage of pandemics, primary health care (PHC) is the first point of contact with the health system for people. This study aimed to find the leading roles and challenges of the PHC system in dealing with the outbreak of infectious diseases.

Methods: The current scoping review was conducted in 2022 using the Arkesy and O'Malley framework. A bibliographic search was conducted in PubMed, Web of Science, and Scopus databases. Following a Google Scholar search, a manual search in some journals, reference checks for articles, and a review of organizational reports, websites, and other sources of information were also conducted. Data were analyzed using the content-analysis method.

Findings: Finally, 65 documents (42 articles and 23 reports, books, and news) were included in the study. Initially, 626 codes were extracted, and 132 final codes were categorized into eight main themes and 44 sub-themes. The main themes for the roles of PHC included: service provision, education and knowledge, surveillance, access, coordination and communication, management and leadership, infrastructure change and rapid preparation, and patient and community management. Regarding the challenges faced by PHC in the epidemic of infectious diseases, 24 key challenges were identified and categorized into four major areas.

Conclusions: Based on the results of the present study, there is a need for further studies to formulate and theorize the specific roles of PHC in managing infectious disease epidemics. The results of this study can be utilized by researchers and officials to inform their efforts in addressing this purpose.

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初级卫生保健系统在流行病管理中的作用和挑战:范围界定审查。
背景和目的:在流行病的早期阶段,初级卫生保健是人们与卫生系统的第一个接触点。本研究旨在发现PHC系统在应对传染病爆发方面的主导作用和挑战。方法:目前的范围界定审查于2022年使用Arkesy和O'Malley框架进行。在PubMed、Web of Science和Scopus数据库中进行了文献检索。在谷歌学者搜索之后,还对一些期刊进行了手动搜索,对文章进行了参考资料检查,并对组织报告、网站和其他信息来源进行了审查。使用内容分析方法对数据进行分析。研究结果:最后,65篇文献(42篇文章和23篇报道、书籍和新闻)被纳入研究。最初,提取了626个代码,132个最终代码被分为8个主主题和44个子主题。初级保健作用的主要主题包括:服务提供、教育和知识、监督、获取、协调和沟通、管理和领导、基础设施变革和快速准备以及患者和社区管理。关于初级保健在传染病流行中面临的挑战,确定了24个关键挑战,并将其分为四个主要领域。结论:根据本研究的结果,有必要进一步研究PHC在管理传染病流行中的具体作用,并将其理论化。研究人员和官员可以利用这项研究的结果来告知他们为实现这一目标所做的努力。
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