Primary Care Research Priorities in Low-and Middle-Income Countries

The Article in Brief

Primary Care Research Priorities in Low- and Middle-Income Countries

Felicity Goodyear-Smith , and colleagues

Background Primary health care research has advanced in high-income countries, while many low- and middle-income countries are still establishing family medicine as a specialty. As a result, capacity and funding for research on primary health care priorities in low- and middle-income countries is limited. This study aimed to identify and prioritize evidence gaps about the organization of primary health care for practitioners and researchers in low- and middle-income countries.

What This Study Found Primary care research priorities in low- and middle-income countries include integration of care at the public/private interface, secondary care, community services, and models of care and finance to promote equitable access to care. These priorities were developed by a three-round modified Delphi expert panel of primary care practitioners and academics in low- and middle-income countries sampled from global networks using web-based surveys. They generated an initial list of more than 1,000 research ideas, which researchers synthesized into 36 organizational and 31 finance questions. The final four prioritized questions on organization address primary/secondary care transitions, horizontal integration within a multidisciplinary team, integration of private and public sectors, and ways to support successfully functioning primary health care teams. Corresponding finance questions address payment systems to increase access and availability of primary care, mechanisms to encourage governments to invest in primary care, the ideal proportion of a health care budget devoted to primary care, and factors to improve workforce distribution. Panelists have developed country-specific research implementation plans for prioritized questions, which will be presented to potential research funders.