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Primary healthcare (PHC) plays a crucial role in improving health outcomes and reducing healthcare burden, especially in low-to-middle-income countries (LMICs). However, PHC has not received adequate attention in Pakistan despite its recognized importance. This study aims to examine the current state of PHC in Pakistan, identifying factors compromising its quality and effectiveness.
Methods:
To find relevant data, the authors conducted a thorough literature search on PubMed, Google Scholar, and Cochrane Library from inception till 2 July 2022, without any language restriction. The following keywords were employed during the literature search, separated by Boolean operators AND, OR: “Primary Healthcare”, “PHC”, “Healthcare primary”, “Primary Health”, and “Pakistan”.
Results:
Pakistan’s PHC infrastructure shows promise, with a considerable number of healthcare facilities in place. However, various factors hinder its effectiveness and compromise the quality of care provided. Insufficient investment, resource constraints, inadequate training of healthcare providers, lack of oversight, and limited access to essential medicines and equipment are some of the key challenges observed. Improving PHC in Pakistan is vital for addressing the population’s healthcare needs, particularly in rural areas. Adequate investment, enhanced training programs, improved oversight mechanisms, and increased availability of essential resources are necessary to strengthen the PHC system. By prioritizing PHC and addressing the identified challenges, Pakistan can enhance healthcare access, reduce healthcare burden, and improve overall health outcomes for its population.
Conclusion:
It is high time LMICs like Pakistan recognize PHC as the most economically feasible pathway toward accomplishing healthcare targets and adopt adequate measures to elevate its standards.
Current clinical practice guidelines have suggested that each individual with knee osteoarthritis (OA) should receive three core treatments from their health care provider. These core treatments comprise of exercise, education and weight loss. Identification of the health care and rehabilitation needs of individuals with knee OA in rural areas are imperative for focusing service delivery in a specific context in order to empower the individual. The aim of this study was to explore the rehabilitation needs of individuals with knee OA living in rural Western Cape in order to identify the gaps in services offered and inform rehabilitation programmes in these settings.
Methods:
Semi-structured in-depth individual interviews were performed on 16 individuals with knee OA living in rural settings of the Western Cape, South Africa. A deductive data analysis approach was used and the needs of the individuals were identified and categorised for interpretation and comparison with the reported services received.
Findings:
The three major themes identified were ‘I would like to know more’, ‘There’s not much support from the clinic’ and ‘I don’t feel myself anymore’. These themes relate to the lack of disease-specific education, barriers in the health systems and service delivery resulting in individuals lack of self-worth and poor mental wellbeing. The results revealed the integral relationship between health care systems, service delivery and the effect on patient wellbeing.
Conclusion:
The rehabilitation needs of individuals with knee OA in rural areas advocates for addressing barriers in rural primary health care system such as adequate human resources, referral systems and continuity of care. This will allow for a comprehensive, person-centred and context-specific multidisciplinary approach focused on empowering individuals with knee OA through disease-specific education, improving functional participation and symptom management strategies. This could improve the social inclusion and mental wellbeing of individuals living with knee OA.
In resource-constrained settings, primary health centers (PHCs) are critical for universal health coverage. Laboratory service is one of its important components. While PHC and its performance are focused, its laboratory service has been neglected in developing countries like India.
Aim:
To determine the role of different level of PHC laboratory services on the overall PHC performance.
Methods:
Cross-sectional study based on 42 PHCs of Osmanabad District, Maharashtra, India was performed. The study used levels of laboratory services in PHC as independent parameter and PHC outpatient department (OPD) visits per day (≤ 80 versus > 80) as dependent parameter. The control parameters used in the study were number of medical doctors, availability of laboratory technicians (LTs) and population coverage by PHC. Field visit was done to collect data on levels of laboratory services, but secondary source was used for other parameters. The logistic regression analysis was performed in study.
Findings:
The study found variation in PHC population coverage (10 788–74 702) and OPD visits per day (40–182) across PHC. Strong positive association was observed between levels of laboratory services and number of OPD visits per day in PHC. PHC offering both malaria and tuberculosis in-house testing had higher odds (4.81) of getting more OPDs (≥ 80 OPD visits per day) as compared to PHC not offering in-house testing facility for malaria and tuberculosis. This association was stronger in PHCs with lower population coverage (0–75 quartile) as compared to PHCs with higher population coverage (75–100 quartile).
Conclusion:
Focus on laboratory services is needed to enhance the existing PHCs performance. Skill-up gradation of existing LT could help in improving the contribution of the existing laboratories in PHC functioning.