Strengthening primary health care service competency: a scoping review of challenges, influencing factors, and enhancement strategies

加强基层医疗服务能力:挑战、影响因素和提升策略的范围界定综述

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Abstract

OBJECTIVE: This scoping review aims to evaluate the factors influencing the service capacity of primary health care (PHC) institutions and to identify strategies for their development. METHODS: We conducted a scoping review based on Arksey and O'Malley's framework and systematically searched PubMed, Web of Science, and SCOPUS for studies published from January 2014 to December 2024. Eligible research addressing PHC capacity-building interventions across diverse health systems was synthesized thematically. RESULTS: This scoping review synthesized evidence from 76 publications (2014-2024) addressing PHC competency enhancement, comprising original research articles (63.2%, n = 48) and systematic/scoping reviews (36.8%, n = 28). Key challenges identified included workforce shortages, inequitable resource allocation, fragmented policy frameworks, limited integration of health information technologies, and persistent inequities in service delivery. Strategies to strengthen PHC capacity centered on workforce development, technology-enabled innovation, equitable service models, and interdisciplinary collaboration. CONCLUSION: Strengthening PHC capacity requires integrated approaches, including localized workforce training, technological adoption, optimized equity in service provision, and enhanced interdisciplinary cooperation. These approaches provide context-sensitive and equity-oriented pathways for building sustainable PHC systems-particularly in resource-constrained settings-supporting progress toward Universal Health Coverage and reducing global health disparities. SYSTEMATIC REVIEW REGISTRATION: Registration DOI: 10.17605/OSF.IO/MDR73.

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