Strengthening primary health care for effective response to pandemics: a systematic review.

Background: Affordability, accessibility and quality of services provided by a primary healthcare system can contribute significantly to the mitigation and management of a pandemic or disease outbreak. A strong primary healthcare system will mitigate the pressure on health systems during crises.

Aims: We aimed to identify the specific capabilities required to establish a resilient primary healthcare system that could respond effectively to a health crisis, and highlight any research gaps.

Methods: A bibliographic search was conducted on PubMed, Scopus, Web of Science, and ProQuest from 2000 to 2021. Using extracted data, we mapped the studies and categorized published research into a framework of 6 building blocks. A graphical and tabular representation of the data was then provided.

Results: A total of 4276 studies were retrieved, out of which 28 met the inclusion criteria for the systematic review. Data extraction was based on the study design, year of publication, country, type of communicable disease, and main interventions used for building resilient primary healthcare systems. Most of the studies were conducted in 2020 and 2021 during the COVID-19 pandemic and many of them emphasized digital health.

Conclusion: This review summarizes more than 20 years of research on how primary healthcare systems responded to public health emergencies. It provides a broad overview of the subject matter and existing research gaps for intervention planning and policymaking.