Primary health care research & development最新文献

{"title":"Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions.","authors":"Nikita Kartikapallil, Nicolle Caicedo Arroyave, Jonathan Taylor, Ishveer Sanghera, Mohammad Reduanul Alam, Annabel Lines, Emily Owen-Boukra, Tanya Cohen, Nia Roberts, Victoria Tzortziou Brown, Geoff Wong, Kamal Mahtani, Sophie Park","doi":"10.1017/S1463423626101212","DOIUrl":"https://doi.org/10.1017/S1463423626101212","url":null,"abstract":"<p><strong>Background: </strong>Continuity of care refers to the consistent and coordinated delivery of healthcare services over time. Continuity has been associated with improvements in morbidity and mortality, yet its decline has been identified as a significant concern amid increasing pressures in primary care.</p><p><strong>Aim: </strong>This review aimed to inform current policy initiatives by synthesizing evidence on how continuity of care is measured, the current challenges faced and proposed future interventions in UK general practice.</p><p><strong>Methods: </strong>We conducted a literature search for articles published before 15 February 2024, to explore continuity in UK primary care. Screening and data extraction followed PRISMA Scoping Review guidelines, with all studies undergoing double screening to determine eligibility.</p><p><strong>Findings: </strong>A total of 180 papers were included (95 quantitative, 76 qualitative and 9 mixed-methods). Across the literature, continuity of care was most commonly conceptualized and measured as relational continuity, the Usual Provider of Care (UPC) Index was the most commonly used metric. Informational and managerial continuity were rarely assessed. Certain patient groups, including those with long-term conditions, mental health needs, and multimorbidity, were reported to place greater value on continuity of care. Higher relational continuity was associated with improved patient satisfaction, care coordination and reduced hospital admissions. However, sustaining continuity was frequently challenged by workforce pressures and fragmented information transfer. Although formal and informal interventions to enhance continuity were described, tensions between continuity and access persisted, and continuity was reported to vary across patient groups.</p><p><strong>Conclusion: </strong>The decline in continuity of care has implications for patient experience and system outcomes. This review highlights the need for system-level approaches and national policy reforms to support continuity, while addressing workforce constraints, access pressures and unequal experiences of care. Further research is needed to evaluate the effectiveness and sustainability of continuity-enhancing interventions and to identify any potential unintended consequences.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e55"},"PeriodicalIF":1.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing knowledge and lifestyle behaviours for hypertension management among adults in urban Ghana: a cross-sectional study.","authors":"Theodora Ojangba, Solomon Boamah, Yudong Miao, Shen Zhanlei, Richard Dormatey, Dongfang Zhu, Robert Dedi, Wenyong Dong, Qiuping Zhao, Baoyong Hua","doi":"10.1017/S1463423626101133","DOIUrl":"https://doi.org/10.1017/S1463423626101133","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess knowledge, lifestyle behaviours, and sociodemographic associations regarding hypertension control among adults in urban Ghana.</p><p><strong>Background: </strong>Hypertension is a major contributor to cardiovascular morbidity and mortality in Ghana. However, data on population-level knowledge of its risk factors and related lifestyle behaviours in urban settings remain limited.</p><p><strong>Methods: </strong>A cross-sectional analytical survey was conducted between August 2023 and September 2024 across four urban regions. Using stratified convenience sampling, 7096 adults aged 18-67⁺ years were recruited. Data on sociodemographic, lifestyle behaviours, and hypertension knowledge were collected via a structured questionnaire.</p><p><strong>Findings: </strong>Participants had a mean age of 37.27 (±8.73) years, with a majority being female (63.85%) and married (97.66%). Educational attainment varied. Females constituted most hypertensive cases, particularly for stage 2 hypertension, while males had a notably higher prevalence of pre-hypertension among those aged 27-53 years. Age and body mass index showed significant positive correlations with systolic and diastolic blood pressure (<i>p</i> < 0.01). Men were significantly more likely to smoke and consume alcohol (<i>p</i> < 0.01). Logistic regression indicated that regular exercise reduced the odds of hypertension diagnosis (OR = 0.72, CI: 0.54-0.96), while older age increased the odds. The study underscores the need for targeted public health strategies. Priorities include promoting physical activity and weight management, alongside smoking/alcohol cessation programs tailored for high-risk men. Early intervention for younger adults with pre-hypertension and enhanced educational outreach for less-educated groups are crucial.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e53"},"PeriodicalIF":1.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting medication reconciliation in primary care: a theory-informed qualitative study in Portugal.","authors":"Raquel Ascenção, João Costa, Paula Broeiro-Gonçalves","doi":"10.1017/S1463423626101200","DOIUrl":"https://doi.org/10.1017/S1463423626101200","url":null,"abstract":"<p><strong>Aim: </strong>To explore behavioural determinants influencing General Practitioner (GP)-led medication reconciliation (MedRec) and inform the development of a theory-informed implementation strategy tailored to the primary care context.</p><p><strong>Background: </strong>Despite national and international recommendations endorsing MedRec to reduce medication errors, its consistent implementation in primary care remains limited.</p><p><strong>Methods: </strong>We conducted a qualitative study involving GPs working in the largest Health Region in Portugal, building on findings from preceding quantitative studies. Data were analysed using a Theoretical Domains Framework (TDF)-informed approach. Key determinants were mapped to intervention functions using the Behaviour Change Wheel (BCW), and candidate behavioural change techniques (BCTs) were subsequently proposed.</p><p><strong>Findings: </strong>A total of 22 GPs participated in three focus group discussions. The 'Environmental context and resources' domain gathered the most coded segments, related to patients, other health professionals, electronic health records, and time constraints, mainly reflecting perceived barriers. 'Knowledge' and 'Skills' emerged as key domains, with ambiguity in the MedRec definition undermining its explicit recognition and influencing other domains. Facilitators included GPs' commitment to patient safety aligned with GPs' professional role. The interplay between barriers and facilitators suggested a cascading effect across domains. Candidate BCTs proposed to address these determinants included feedback on behaviour/outcomes, self-monitoring, prompts/cues, restructuring and adding objects to the environment. This study provides a theory-informed foundation for designing tailored implementation strategies to support MedRec practices in Portuguese primary care. Future work should focus on assessing the appropriateness, feasibility and acceptability of the proposed BCTs within the constraints of real-world primary care settings.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e54"},"PeriodicalIF":1.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing an intention to use intrauterine device among family planning users in Southwestern Ethiopia.","authors":"Afework Tadele, Zerhun Asefa, Alemi Kebede, Tekle Wakjira, Demisew Amenu","doi":"10.1017/S1463423626101182","DOIUrl":"10.1017/S1463423626101182","url":null,"abstract":"<p><strong>Introduction: </strong>An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world and safe for nearly all women. However, very few women in Southwestern Ethiopia use.</p><p><strong>Objectives: </strong>To identify factors influencing an intention to use the intrauterine device among family planning users in Southwestern, Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted among 784 modern family planning users from 15^th October to 15^th November 2020. An interviewer-administered questionnaire was used. Estimates were generated using logistic regression model.</p><p><strong>Results: </strong>Thirty percent intended to use IUD. The most commonly cited reasons for their lack of an intention to use IUD were fear of side effects, lack of knowledge, and husband disapproval. Being able to read and write (AOR = 3.33 [95% C.I. 1.48, 7.49]) compared to those unable to read and write; Being rich (AOR = 1.69 [95% C.I. 1.02, 2.82]) compared to the poor; being knowledgeable about IUD (AOR = 2.74 [95% C.I. [1.67, 4.51]); having higher reproductive health autonomy (AOR = 1.53 [95% C.I. [1.09, 2.16]) were found to be significant factors influencing women's intention to use an IUD.</p><p><strong>Conclusion: </strong>Nearly one-third of women who attend health facilities are currently using contraception reported an intention to use an IUD in the future. Public health interventions should focus on the cited reasons reaching all the community in need, and give priority for women who unable read and write, and lowest wealth status. Further interventional studies were recommended to determine effective interventions to increase women's intention to use intrauterine device.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e51"},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding self-efficacy status and determinant factors among postnatal women in public hospitals of the Gurage Zone, Central Ethiopia: a mixed study design.","authors":"Mangistu Abera, Megertu Obsa Gelmesa, Ayele Sahile Abdo, Keyredin Nuriye Metebo, Aynalem Belay, Aberash Beyene Derribow","doi":"10.1017/S1463423626101224","DOIUrl":"10.1017/S1463423626101224","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding self-efficacy is a mother's confidence in her ability to breastfeed, influencing her decision to do so. Across the world, due to low breastfeeding self-efficacy and limited attention to breastfeeding practices expose mothers and infants to adverse health outcomes and poor mother-child bonding and development. Most previous studies focused on breastfeeding knowledge, but there is limited research on breastfeeding self-efficacy and its associated factors. Thus, this study aimed to assess breastfeeding self-efficacy status and determinant factors among postnatal women in Gurage Zone public hospitals, Central Ethiopia.</p><p><strong>Methods: </strong>A facility-based mixed-method cross-sectional study was conducted among 422 systematically selected women in Gurage Zone public hospitals, Central Ethiopia, from February 15 to March 15, 2025. Data were collected using a pre-tested interviewer-administered questionnaire, entered into Epi-Data 4.1, and analyzed using SPSS 26. Four focus group discussions were conducted with purposive sampling and analyzed thematically. Binary logistic regression identified factors associated with breastfeeding self-efficacy at P < 0.05.</p><p><strong>Results: </strong>In this study, the overall breastfeeding self-efficacy status was 51.3% (95% CI: 47, 56). Women's primary educational attainment (AOR = 1.97; 95%CI:1.01,3.83), secondary and above educational attainment (AOR = 3.30; 95%CI: 1.87,5.85), ANC contacts (AOR = 2.24; 95%CI:1.37,3.63), breastfeeding experience (AOR = 3.59; 95%CI:2.10,6.13), moderate perceived social support (AOR = 2.96; 95%CI:1.47,5.55), and high perceived social support (AOR = 3.23; 95%CI:2.02,6.59) were significantly associated with breastfeeding self-efficacy.</p><p><strong>Conclusion: </strong>In this study, 48.7% lacked breastfeeding confidence. Educational status, ANC contact, breastfeeding experience, and perceived social support were associated with breastfeeding self-efficacy. Therefore, strengthening health education and counseling is needed to improve postpartum women's breastfeeding confidence..</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e52"},"PeriodicalIF":1.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the association between the levels of physical activity and cognitive perceptions of physicians and the frequency of family doctors prescribing exercise.","authors":"Kübra Kurt, Pınar Döner Güner","doi":"10.1017/S1463423626101121","DOIUrl":"10.1017/S1463423626101121","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to determine the relationship between the physical activity levels and cognitive perceptions of physicians and the frequency of exercise prescribed by primary care physicians.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with 221 primary care physicians. A questionnaire of three sections was administered, including questions prepared according to the American College of Sports Medicine (ACSM) recommendations evaluating the current practices of the physicians on the subject of prescribing exercise, the General Practice Physical Activity Questionnaire (GPPAQ), Cognitive Behavioural Physical Activity Questionnaire (CBPAQ).</p><p><strong>Results: </strong>A significant relationship was determined between the daily physical activity of the physician and exercise prescribing rates (<i>P</i> = 0.005). From the data obtained from the GPPAQ and the CBPAQ, it was determined that as the activity level increased, so the Outcome Expectation (<i>P</i> < 0.001), Self-regulation (<i>P</i> < 0.001), Total Cognitive Activity (<i>P</i> < 0.001) points increased. The frequency of prescribing exercise was found to be <20% for all chronic diseases for which exercise is known to be effective. A significant relationship was determined between prescribing exercise and the total number of correct responses to the questions measuring the level of knowledge according to the ACSM recommendations (<i>P</i> < 0.001). Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data, while Pearson, likelihood ratio, and chi-square tests were used for analyzing relationships between categorical variables.</p><p><strong>Conclusion: </strong>Incorporating exercise prescription training into the core medical and family medicine curricula may increase physicians' self-efficacy and contribute to overcoming barriers in prescribing exercise.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e50"},"PeriodicalIF":1.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the feasibility of a pre-triage photo and questionnaire protocol in GP triage: a quality improvement study.","authors":"Karan Gupta, Caroline Thurston, Harvey McGarry, Angela Bennett","doi":"10.1017/S1463423626101169","DOIUrl":"10.1017/S1463423626101169","url":null,"abstract":"<p><strong>Background: </strong>Efficient triage in general practice is critical to optimize appointment allocation and minimize patient delays. Delays in receiving clinical information, such as photographs or symptom questionnaires, lead to unnecessary consultations and inefficiencies. This study evaluated the feasibility and impact of a structured pre-triage protocol requesting photos and questionnaires for common conditions (skin, eye, tonsillitis, and urinary tract infections).</p><p><strong>Methods: </strong>A pre-post intervention quality improvement project was conducted in a UK general practice. Triage administrators were instructed to proactively request photographs for skin and eye complaints and symptom questionnaires for tonsillitis and UTIs at initial patient contact. Outcomes included process metrics (number of pre-triage requests, proportion of cases managed directly by the triage GP) and subjective measures of ease, speed, satisfaction, and confidence.</p><p><strong>Results: </strong>The protocol increased photo requests for skin (mean increase 4.0/session, Cohen's <i>d</i> = 7.77) and eye (2.2/session, <i>d</i> = 4.09) conditions, while questionnaire requests remained unchanged. The proportion of skin cases managed directly by the triage GP increased significantly (from 0.2 to 2.2 cases/session, <i>d</i> = 1.65), and eye case management also improved. Questionnaire-based pathways showed minimal change in efficiency or direct management. Subjective feedback indicated a slight reduction in triage speed, but ease and satisfaction were maintained, while diagnostic confidence increased, particularly for photo-supported conditions.</p><p><strong>Conclusion: </strong>A structured pre-triage protocol is feasible, acceptable, and potentially effective in enhancing triage efficiency, particularly for visually assessable conditions like skin and eye presentations. By enabling earlier access to essential information, such protocols may reduce unnecessary consultations, improve workflow, and support clinician confidence.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e49"},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From silos to synergy: assessing tuberculosis basic management units readiness for integrated diabetes mellitus care across different districts of Pakistan.","authors":"Saima Aleem, Saima Afaq, Bilal Ahmad, Zala, Haroon Latif Khan, Zohaib Khan","doi":"10.1017/S146342362610111X","DOIUrl":"10.1017/S146342362610111X","url":null,"abstract":"<p><strong>Background: </strong>The dual burden of tuberculosis (TB) and diabetes mellitus (DM) presents a growing challenge for health systems in low- and middle-income countries (LMICs), including Pakistan. Despite global and national policies advocating for integrated care, evidence on health facility readiness to operationalize integration remains scarce. This study assessed the readiness of TB basic management units (BMUs) to deliver integrated TB-DM care and explored implementation barriers using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Methods: </strong>We conducted an explanatory sequential mixed-methods study from September 2024 to February 2025 across 13 TB BMUs in five districts of Pakistan. Quantitative readiness data were collected using a structured tool adapted from the WHO Service Availability and Readiness Assessment (SARA), generating a composite score across four domains. Subsequently, qualitative data were gathered through multi-stakeholder focus group discussions with healthcare providers, facility managers, patients, caregivers, and policymakers. Reflexive thematic analysis was conducted and mapped to CFIR Inner Setting constructs to contextualize quantitative findings.</p><p><strong>Results: </strong>Only one facility demonstrated high readiness, while 12 showed low readiness. Facilities lacked routine comorbidity screening, trained staff, diagnostic capacity, and essential medicines. Key barriers included inadequate infrastructure, workforce shortages, fragmented information systems, and low prioritisation of integrated care. Financial constraints and limited coordination further hindered implementation.</p><p><strong>Conclusion: </strong>This study highlights critically low readiness among TB facilities in different districts of Pakistan to deliver integrated TB-DM care, reflecting systemic weaknesses across core domains. Strengthening systems, building capacity, and improving integration strategies are essential to bridge gaps between policy and practice.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e47"},"PeriodicalIF":1.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building bridges: the integral presence of audiologists and speech-language pathologists in comprehensive interprofessional primary care teams.","authors":"Grecia Alaniz, Jana Bataineh, Robin O'Hagan, Sheila Moodie, Margaret Pichora-Fuller, Jennifer Cameron-Turley, Bonnie Cooke, Anne Carey, J B Orange, Miranda Cooper, Danielle Glista","doi":"10.1017/S1463423626101078","DOIUrl":"10.1017/S1463423626101078","url":null,"abstract":"<p><strong>Aim: </strong>This article provides an overview of the professional roles of audiologists and speech-language pathologists (S-LPs) in interprofessional primary care.</p><p><strong>Background: </strong>Current published literature considering primary care delivery within comprehensive interprofessional teams contains little representation of professionals from the fields of audiology and speech-language pathology.</p><p><strong>Methods: </strong>An illustrative case scenario highlights the key roles of audiologists and S-LPs in primary care, and how collaborative relationships within an interprofessional primary care team structure can enhance the overall quality of care provided to patients and to their families.</p><p><strong>Findings: </strong>As experts in the prevention, diagnosis, and rehabilitation of communication disorders, with S-LPs supporting speech and swallowing disorders and audiologists supporting hearing and vestibular disorders, S-LPs and audiologists are well-positioned to support meaningful participation in primary care across the lifespan and in collaboration with different healthcare professionals, including patients experiencing cognitive decline.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e48"},"PeriodicalIF":1.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory action research to align Health and Demographic Surveillance System (HDSS) priorities with community needs in Uttar Pradesh, India.","authors":"Shalini Singh, Raghukul Ratan Pandey, U Venkatesh, Ram Shankar Rath, Anil Ramesh Koparkar, Pradip Kharya, Hariom Pandey, Neetisha Besra, Hari Shanker Joshi, Anand Mohan Dixit, Vikasendu Agarwal, Brian Wahl","doi":"10.1017/S1463423626101157","DOIUrl":"10.1017/S1463423626101157","url":null,"abstract":"<p><strong>Background: </strong>Participatory action research (PAR) methods effectively engage communities in identifying health priorities in low-resource settings. This study applied PAR methods during the establishment of a Health and Demographic Surveillance System (HDSS) in Gorakhpur, Uttar Pradesh, India.</p><p><strong>Methods: </strong>We implemented seven PAR methods across rural and urban populations: transect walks, resource mapping, social mapping, seasonal mapping, focus group discussions, semi-structured interviews, and community ranking exercises. Data were collected in September 2023 following facilitator training. Visual materials and field notes were thematically categorized, while audio-recorded interviews were transcribed, translated, and analysed with combined inductive-deductive thematic analysis. Community health priorities were quantitatively analysed through free listing, pile sorting, and ranking.</p><p><strong>Results: </strong>Five major themes emerged: (1) Community context revealed diverse caste compositions and essential infrastructure; (2) Health priorities included acute conditions (fever, joint pain), chronic diseases (hypertension, diabetes), healthcare access limitations, and WASH issues; (3) Key contributors to poor health encompassed inadequate WASH facilities, limited health awareness, and discrimination; (4) Healthcare access barriers included absent primary care facilities, financial constraints, limited transportation, and poor service quality; (5) Community suggestions addressed both social determinants and healthcare services, emphasizing governance participation, WASH interventions, and improved healthcare infrastructure.</p><p><strong>Conclusions: </strong>PAR methods successfully identified community-defined health needs and barriers, demonstrating consistency across urban and rural settings. Community members provided concrete recommendations for health system improvements, validating the importance of incorporating local voices in HDSS design. The alignment between community priorities and documented regional health challenges underscores how participatory methods can shape surveillance activities to foster sustainable health improvements and enhance governance capacities. These insights directly informed HDSS operational plans, creating a foundation for responsive and equitable health surveillance systems.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e46"},"PeriodicalIF":1.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}