ArticleBMJ open2025
Sustainability of health system strengthening interventions implemented at primary healthcare level: a scoping review.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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
3 citing papers in PubMed.
- Strengthening Antimicrobial Stewardship in Nigeria: Qualitative and Quantitative Insights into Barriers, Enablers, and Implementation Strategies (2015-2025).Open forum infectious diseases · 2026Article
- Interdisciplinary training on noncommunicable diseases and sustained change in primary health care in the context of health reform, COVID-19, and war in Ukraine: A repeated qualitative study, 2016-2022.BMC public health · 2026Article
- Implementation pathways of a health services delivery redesign model to improve maternal and newborn outcomes in Kenya.BMJ global health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesConsiderable resources are invested in health system innovation and strengthening. This calls for efforts to ensure the sustainability of such interventions. We conducted a scoping review to identify factors influencing the sustainability of externally funded health system strengthening interventions targeting primary healthcare, the sustainability outcomes observed in such interventions and the methods used to measure sustainability.
designScoping review following the Joanna Briggs Institute scoping review guidelines. DATA SOURCES: Web of Science, Ovid Medline and Embase databases were searched through 11 March 2024. ELIGIBILITY CRITERIA: Studies in English with no restriction on study type or country. Externally funded health system strengthening interventions targeting primary health systems and measuring sustainability. DATA EXTRACTION AND SYNTHESIS: One reviewer screened all titles and abstracts, and two independent pairs of reviewers read full texts. Relevant study data were extracted from the articles and descriptively analysed.
resultsFrom the 6439 titles retrieved, eight eligible studies were identified and included in the final analysis. Only four studies presented a sustainability definition. Institutionalisation and continued programme activities were described four times as sustainability outcomes, followed by capacity building twice and continued health impact and benefits once. Sustainability was assessed in five studies after intervention completion and in three studies during the implementation period. The sustainability factors were mostly related to processes (n=19), inner context (n=18), intervention characteristics (n=12) and outer context (n=11), with stakeholder engagement and partnership (n=6) as well as funding (n=3) being the most reported factors.
conclusionThis review highlights the limited documentation on the sustainability of externally funded health system strengthening interventions. Sustainability was mainly assessed retrospectively. Influencing factors spanned over all categories of the integrated sustainability framework, with stakeholder engagement and funding playing key roles. Planning for sustainability assessments with clear definitions, methods and timeframes can enhance evidence on achieving lasting impacts of health system strengthening interventions. REGISTRATION: Open Science Framework, https://osf.io/hazqp/?view_only=d53472afbba447e790049d81ca60aa29.
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.