ReviewHealth policy and planning2024
First referral hospitals in low- and middle-income countries: the need for a renewed focus.
Review in Health policy and planning, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medical specialists in LMICs: a systematic review and best-fit framework synthesis of the evidence on their roles and contribution to health systems.BMJ global health · 2026Pooled it
- Responsibility without autonomy: exploring the emergence of distributed leadership in a district hospital of the Western Cape province, South Africa.Health policy and planning · 2026Article
- Counter-verification in performance-based financing: key insights from the Côte d'Ivoire experience.Global health action · 2025Article
- Strengthening hospital infrastructure in a war context: the case of the Mopti regional hospital.Globalization and health · 2025Article
- First referral hospitals in low-resource settings: a narrative review of expectations for clinical service provision.Health policy and planning · 2025Review
- Provision of inguinal hernia surgery in first-referral hospitals across low- and middle-income countries: Secondary analysis of an international cohort study.World journal of surgery · 2025Article
- The district hospital: A rare story of success and a way forward.African journal of primary health care & family medicine · 2025Article
- Exploring the concept of surgical transition: surgical activity in the light of economic development in Sierra Leone, Liberia, Ghana and India.Frontiers in surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
First referral hospitals (FRHs) are the hospitals closest to the community, which offer expertise or technologies to complement more widely available 'basic' ambulatory care or inpatient care. Despite having been a subject of interest in global health policy in the latter half of the 20th century, in more recent decades, they appear to have been overshadowed. This paper reviews what is understood by FRH, drawing on both academic and policy literature, complemented by specific country case studies. We undertook three reviews: a grey literature review of global and regional policy reports and documents, a structured review of the academic literature on FRH and a review of FRH-related policies in eight countries. Our findings indicate that there is confusion regarding the definitions and roles of FRH; they have fallen off the policy agenda globally and they suffer from lack of advocates in part related to the absence of cohesive definition. Meanwhile, these facilities continue to fulfil important functions in health systems in low- and middle-income countries, and expectations for service delivery remain high. In light of these findings, this paper calls for renewed interest and investment in FRH from the global health academic and policy-making community.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.