Evidence of integrated health service delivery during COVID-19 in low and lower-middle-income countries: protocol for a scoping review

IntroductionThe importance of integrated, people-centred health systems has been recognised as a central component of Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can withstand the shock of health emergencies. However, there is a dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness, response, and recovery in low-income and lower-middle-income countries (LMICs). Thus, the authors are organising a scoping review aiming to explore the application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs.Methods and analysisThis scoping review adheres to the six steps for scoping reviews from Arksey and O’Malley. Peer-reviewed scientific literature will be systematically assembled using a standardised and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the WHO’s Global Research Database on COVID-19 and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full-text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrix.Ethics and disseminationNo ethical approval is required for the review. The study will be conducted from June 2020 to May 2021. Results from this scoping review will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic in LMICs. The findings will be developed into reports and a peer-reviewed article and will assist policy-makers in making pragmatic and evidence-based decisions for current and future pandemic responses.

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Evidence of integrated health service delivery during COVID-19 in low- and middle-income countries: protocol for a scoping review

10.1101/2020.07.23.20160721 ◽

2020 ◽

Author(s):

Rachel Neill ◽

Md Zabir Hasan ◽

Priyanka Das ◽

Vasuki Venugopal ◽

Nishant Jain ◽

...

Keyword(s):

Health Service ◽

Service Delivery ◽

Health Systems ◽

Scoping Review ◽

Health Service Delivery ◽

World Health ◽

Research Database ◽

Middle Income ◽

Middle Income Countries ◽

Integrated Health

Introduction The importance of integrated, people-centered health systems has been recognized as a central component of achieving Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can stand the shock of health emergencies. However, there is dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness in low- and low-middle income countries (LMICs). Thus, the authors are organizing a scoping review aiming to explore application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs. Methods and analysis This scoping review adheres to the six steps for scoping reviews from Arksey and OMalley (2005). Peer reviewed scientific literature will be systematically assembled utilizing a standardized and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the World Health Organization Global Research Database on COVID-19, and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrices. Ethics and dissemination No ethical approval is required for the review. The study will be conducted from June to December 2020. Results from this study will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic. The findings will be developed into reports and a peer-reviewed articles and will assist policy makers in making pragmatic and evidence-based decisions for current and future pandemic response.

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Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries

BMJ Global Health ◽

10.1136/bmjgh-2021-005667 ◽

2021 ◽

Vol 6 (6) ◽

pp. e005667

Author(s):

Md Zabir Hasan ◽

Rachel Neill ◽

Priyanka Das ◽

Vasuki Venugopal ◽

Dinesh Arora ◽

...

Keyword(s):

Health Service ◽

Service Delivery ◽

Health System ◽

Scoping Review ◽

Low Income ◽

Building Blocks ◽

Health Service Delivery ◽

Middle Income ◽

Published Evidence ◽

Integrated Health

BackgroundIntegrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features.MethodsA systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review.ResultsThe literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government’s stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration.ConclusionA wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.

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1. Innovative Health Service Delivery Models in Low- and Middle-Income Countries – What Can We Learn from the Private Sector?

Private Sector Entrepreneurship in Global Health ◽

10.3138/9781487515904-004 ◽

2018 ◽

pp. 3-25

Keyword(s):

Health Service ◽

Service Delivery ◽

Private Sector ◽

Health Service Delivery ◽

Middle Income ◽

Middle Income Countries ◽

Service Delivery Models ◽

Delivery Models ◽

Low And Middle Income

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NGOs’ experiences of navigating the open access landscape

F1000Research ◽

10.12688/f1000research.17359.2 ◽

2019 ◽

Vol 8 ◽

pp. 1563

Author(s):

Nilam McGrath

Keyword(s):

Open Access ◽

Health Service ◽

Service Delivery ◽

Health Research ◽

Research Programme ◽

Health Service Delivery ◽

Communicable Diseases ◽

Research Institutions ◽

Middle Income ◽

Middle Income Countries

Grant-led consortia working in the global development sector rely on the input of local and national non-government organisations in low- and middle-income countries. However, the open access mandates and mechanisms embedded within grants and promoted by funders and publishers are designed almost exclusively with large universities and research institutions in mind. Experiences from the consortium of health research non-government organisations comprising the Communicable Diseases Health Service Delivery research programme show that implementing open access mandates is not as simple or frictionless as it initially appears.

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