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Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review

Author

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  • Bo Li

    (Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China)

  • Juan Chen

    (Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
    Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, China)

Abstract

Providing access to a range of basic health services, community-based primary health care (CB-PHC) plays a vital role in achieving the goal of health for all. Driven by a strong political commitment, China’s CB-PHC progress in the past decade has been swift and impressive. However, a well-functioning delivery system for care has yet to be established. This systematic mapping review synthesizes selected evidence on barriers to CB-PHC delivery in urban China and draws lessons for policy development. We performed searches on five electronic databases: CINAHL, MEDLINE, Scopus, Web of Science, and China National Knowledge Infrastructure, and included studies published between 2012 and 2021. The Downs and Black and Critical Appraisal Skills Program checklists were used to assess the quality of eligible papers. We conducted our searches and syntheses following the framework set out in the Primary Health Care Performance Initiative (PHCPI). We synthesized the results of the included studies using a thematic narrative approach and reported according to PRISMA guidelines. Six salient barriers arose from our syntheses of 67 papers: lack of comprehensive health insurance schemes, lack of public awareness, superficial care relationships, gaps in communication, staff shortages and poor training, and second-rate equipment. These barriers are grouped into three subdomains following the PHCPI framework: access, people-centered care, and organization and management. A host of negative impacts of these barriers on community-based health care were also identified. It was not possible to determine clear causes of these barriers from the contributing evidence because of the lack of conceptual frameworks and research methods constraints. Non-eastern regions of China and access-related barriers require further exploration. It follows that, at the national level, the problems are likely more severe than the research suggests.

Suggested Citation

  • Bo Li & Juan Chen, 2022. "Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review," IJERPH, MDPI, vol. 19(19), pages 1-18, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12701-:d:933407
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    References listed on IDEAS

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    2. Huazhang Li & Kun Liu & Jianjun Gu & Yimin Zhang & Yun Qiao & Xiaoming Sun, 2017. "The development and impact of primary health care in China from 1949 to 2015: A focused review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 339-350, July.
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    1. Li, Bo & Chen, Juan & Howard, Natasha, 2023. "Community nursing delivery in urban China: A social power perspective," Social Science & Medicine, Elsevier, vol. 326(C).

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