Evidence of integrated primary-secondary health care in low-and middle-income countries: protocol for a scoping review

Md Zabir Hasan, Shalini Singh, Dinesh Arora, Nishant Jain, Shivam Gupta

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Integrated care is a people-centered health delivery approach that ensures the comprehensiveness, quality, and continuity of service across the settings and levels of health systems. The World Health Organization (WHO) recommends integration across levels and building-blocks of health systems as a prerequisite of Universal Health Coverage (UHC). While health systems of low- and middle-income countries (LMICs) are often fragmented and led by siloed service delivery structure, several LMICs-including India-have attempted health system integration. Several systematic reviews of evidence on healthcare integration from developed countries exist, but no synthesis from LMICs was reported to date. This review will overview the existing evidence of primary-secondary care integration (PSI) in the context of LMICs, aiming to support policy decisions for the effective integration of health delivery systems in India. METHODS: The review will be conducted following the six steps recommend by Arksey and O'Malley. Scientific and grey literature will be systematically selected from PubMed, Embase, Scopus, Web of Science, Global Index Medicus, and electronic repositories (such as WHO, World Bank, Health Policy Plus, and OpenGrey). Using a comprehensive search strategy, literature written in English and published between 2000 and 2020 will be selected, and two independent authors will screen their titles and abstracts. The result will be charted using a data extraction form and reported using tables, figures, and narrative forms. DISCUSSION: No ethical approval is necessary for the review. The final report will be developed with the consultation of other stakeholders and disseminated through workshops, conference papers, and peer review articles. The review will serve as a guiding tool to approach, implement, and test the PSI models in India and other LMICs. SCOPING REVIEW REGISTRATION: https://osf.io/kjhzt .

Original languageEnglish (US)
Pages (from-to)260
Number of pages1
JournalSystematic reviews
Issue number1
StatePublished - Nov 9 2020


  • Ayushman Bharat
  • Health systems
  • India
  • Integrated care
  • Integrated primary-secondary care
  • Low- and middle-income countries
  • Scoping review

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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