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1. Annual Primary Care 2030 Convening: Creating an Enabling Ecosystem for Person-Centered Primary Healthcare Models to Achieve Universal Health Coverage in Low- and Middle-Income Countries

Author

Jessica L. Alpert, Sofiat Akinola, Edward Booty, Dessislava Dimitrova, Thu T. Do, Audu Lucky Emmanuel, Pascal Fröhlicher, Caroline W. Gitonga, Phan Le Thu Hang, Lindsay Hunt, Salim Hussein, Helen Kiarie, Sejal Mistry, Ruth Ngechu, Irina A. Nikolic, Agatha Olago, Todd M. Pollack, Ruben Vellenga, Bram P. Wispelwey, and David B. Duong

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Background: The 2019 United Nations General Assembly High-Level Meeting on Universal Health Coverage and the 2018 Declaration of Astana reaffirm the highest level of political commitment by United Nations Member States to achieve access to health services and primary healthcare for all. Both documents emphasize the importance of person-centered care in both healthcare services and systems design. However, there is limited consensus on how to build a strong primary healthcare system to achieve these goals. Methods: We convened a diverse group of global stakeholders for a high-level dialogue on how to create a person-centered primary healthcare system, using the country examples of the Republic of Kenya and the Socialist Republic of Vietnam. We focused our discussion on four themes to enable the creation of person-centered primary healthcare systems in Kenya and Vietnam: (1) strengthened community, person and patient engagement in subnational and national decision making; (2) improved service delivery; (3) impactful use of innovation and technology; and (4) meaningful and timely use of measurement and data. Findings: Here, we present a summary of our convening’s proceedings, with specific insights on how to enable a person-centered primary healthcare system within each of these four domains. Conclusions: Following the 2019 United Nations General Assembly High-Level Meeting on Universal Health Coverage and the 2018 Declaration of Astana, there is high-level commitment and global consensus that a person-centered approach is necessary to achieve high-quality primary healthcare and universal health coverage. We offer our recommendations to the global community to catalyze further discourse and inform policy-making and program development on the path to Universal Health Coverage by 2030.

Published
2020
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2. The Impact of Oral Health Training for Primary Care Clinicians: A Systematic Review

Author

Jacqueline Cellini, Martell A. Hesketh, Kristen Goodell, Kathleen Dwiel, Russell S. Phillips, Jessica L. Alpert, and Erin E. Sullivan

Subjects
030203 arthritis & rheumatology, business.industry, Oral health education, Oral Health, Audit, Primary care, 030204 cardiovascular system & hematology, Oral health, Interprofessional education, Ambulatory Care Facilities, Physicians, Primary Care, 03 medical and health sciences, 0302 clinical medicine, Nursing, Health care, Inclusion and exclusion criteria, Humans, Medicine, Curriculum, Dental Care, Family Practice, business, Delivery of Health Care, Education, Dental
Abstract

Background and Objectives: Despite recent improvements in access to health care, many Americans still lack access to dental care. There has been a national focus on interprofessional education and team-based care to work toward the integration of services including dental care into primary care. The purpose of this systematic review is to understand the impact of implementing oral health curricula in primary care training on measurable changes in primary care practice. Methods: Researchers utilized a two-step process, first a scoping review and then using the PRISMA systematic review method to develop inclusion and exclusion criteria around audience, curricula, and outcomes to identify practice change due to oral health education curricula delivered in primary care clinician training. Researchers assessed titles, abstracts, and full texts and abstracted data for the review. Results: Researchers reviewed 2,749 articles and found 12 meeting the systematic review criteria. The reported outcomes and evaluations differed for each of the 12 studies identified. Over 40% utilized self-reporting. Seven of the included studies tracked outcomes by checklists embedded in electronic health records changes to well-child visit forms, or chart audits, one of which also tracked billing reimbursements. Conclusions: Oral health curricula for primary care clinicians are too heterogeneous to determine the effects on practice behavior. Future research should focus on developing a clear evaluation framework for measuring practice level changes in primary care settings as a result of implementing an oral health curriculum.

Published
2019
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