Evidence map›Paper›PMID 40447306›Full record

ArticleBMJ global health2025

Role of a primary healthcare approach in COVID-19 pandemic response in the eastern Mediterranean region: multicountry case study synthesis.

Fadi El-Jardali, Nour Ataya, Alexandra Edelman, Shehla Zaidi, Robert Marten, Hassan Salah, Hagar Azab, Faraz Khalid, Awad Mataria, Kumanan Rasanathan

Abstract read
In one paragraph

Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Fadi El-JardaliAmerican University of Beirut, Beirut, Lebanon fe08@aub.edu.lb.ORCID http://orcid.org/0000-0002-4084-6524
Nour AtayaAmerican University of Beirut, Beirut, Lebanon.ORCID http://orcid.org/0009-0007-8525-9888
Alexandra EdelmanMenzies School of Health Research, Alice Springs, Northern Territory, Australia.ORCID http://orcid.org/0000-0002-2021-5266
Shehla ZaidiGlobal Business School of Health, University College London Faculty of Population Health Sciences, London, UK.ORCID http://orcid.org/0000-0001-7620-9247
Robert MartenAlliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0002-2416-2309
Hassan SalahUniversal Health Coverage/ Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Hagar AzabUniversal Health Coverage/ Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Faraz KhalidSpecial Programme on Primary Health Care, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0003-3225-6230
Awad MatariaUniversal Health Coverage/ Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.ORCID http://orcid.org/0000-0001-5499-3667
Kumanan RasanathanAlliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.ORCID http://orcid.org/0000-0001-9347-1765

Funding

World Health Organization 001
6 · The paper itself

Abstract

introductionPrimary healthcare (PHC) can play a critical role in disease preparedness and response. The PHC approach was not always considered in the COVID-19 response in the eastern Mediterranean region (EMR). This article assesses the extent to which a PHC approach was deployed in the pandemic response and identifies barriers, enablers and lessons learnt for strengthening PHC for disease preparedness and response in EMR.

methodsA multicountry synthesis of 17 case studies from EMR was conducted, using an analytical framework building on the three components of PHC framed by the 2018 Astana Declaration and adapted to enable the analysis of pandemic responses, namely the following. (1) How primary care (PC) and essential public health functions were employed to respond to COVID-19? (2) How multisectoral policy and actions were involved in responding to COVID-19? (3) To what extent was engaging and communicating with communities to leverage community resources effective? Countries were classified into three groups based on the level of socioeconomic development, representing the EMR diversity. Deductive content analysis was conducted.

resultsFindings revealed variations across countries in the application of a PHC approach in pandemic response, with Group 1 countries (higher socioeconomic development) swiftly scaling up PC responses, while Groups 2 and 3 countries prioritised secondary and tertiary care responses. Multisectoral coordination, digital health innovations, cross referrals and expanded disease surveillance commonly emerged as new practices in most EMR countries. Uneven regulatory capacity, inadequately equipped PC workforces and insufficient community engagement were key areas requiring further support.

conclusionPriority areas for a comprehensive action agenda for PHC-oriented disease preparedness and response in EMR would benefit from establishing comprehensive PHC-oriented models of care; better resourcing PC; activating an emergency funding pool and strengthening community engagement. Advancing this agenda would contribute to ensuring the health security goal while progressing towards universal health coverage in EMR.

Indexed as

COVID-19PandemicsPrimary Health CareHumansMediterranean RegionSARS-CoV-2COVID-19Decision MakingGlobal HealthHealth policies and all other topics

Identifiers

PMID40447306
PMCPMC12128400

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.