Journal article
Supply-side and demand-side factors affecting allopathic primary care service delivery in low-income and middle-income country cities
The Lancet global health, v 13(5), pp e942-e953
May 2025
PMID: 40288402
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Most people in low-income and middle-income countries (LMICs) now live in cities, as opposed to rural areas where access to care and provider choice is limited. Urban health-care provision is organised on very different patterns to those of rural care. We synthesise global evidence to show that health-care clinics are plentiful and easily accessible in LMIC cities and that they are seldom overcrowded. The costs that patients incur when they seek care are highly variable and driven mostly by drugs and diagnostics. We show that citizens have agency, often bypassing cheaper facilities to access preferred providers. Primary care service delivery in cities is thus best characterised as a market with a diverse range of private and public providers, where patients make active choices based on price, quality, and access. However, this market does not deliver high-quality consultations on average and does not provide continuity or integration of services for preventive care or long-term conditions. Since prices play a key role in accessing care, the most vulnerable groups of the urban population often remain unprotected.
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Details
- Title
- Supply-side and demand-side factors affecting allopathic primary care service delivery in low-income and middle-income country cities
- Creators
- Richard J Lilford (Corresponding Author) - University of BirminghamBenjamin Daniels - Harvard Global Health InstituteBarbara McPake - The University of MelbourneZulfiqar A Bhutta - Aga Khan UniversityRobert Mash - Stellenbosch UniversityFrances Griffiths - University of WarwickAkinyinka Omigbodun - University of IbadanElzo Pereira Pinto, Jr - Knowledge IntegrationRadhika Jain - University College LondonGershim Asiki - African Population and Health Research CenterEika Webb - University Hospitals Birmingham NHS Foundation TrustKatie Scandrett - University of BirminghamPeter J Chilton - University of BirminghamJo Sartori - University of BirminghamYen-Fu Chen - University of WarwickPeter Waiswa - Makerere UniversityAlex Ezeh - Drexel University, Urban Health CollaborativeCatherine Kyobutungi - African Population and Health Research CenterGabriel M Leung - Rockefeller FoundationCristani Machado - Drexel UniversityKabir Sheikh - Dornsife School of Public Health, Drexel University, Philadelphia, PA, USASam I Watson - University of BirminghamJishnu Das - Walsh University
- Publication Details
- The Lancet global health, v 13(5), pp e942-e953
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Community Health and Prevention
- Web of Science ID
- WOS:001481393800001
- Scopus ID
- 2-s2.0-105003302088
- Other Identifier
- 991022064912004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health