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Record W4409754150 · doi:10.1016/s2214-109x(24)00536-9

Policy and service delivery proposals to improve primary care services in low-income and middle-income country cities

2025· review· en· W4409754150 on OpenAlexaff
Richard Lilford, Benjamin Daniels, Barbara McPake, Zulfiqar A Bhutta, Robert Mash, Frances Griffiths, Akinyinka Omigbodun, Elzo Pereira Pinto, Radhika Jain, Gershim Asiki, Eika Webb, Katie Scandrett, Peter J Chilton, Jo Sartori, Yen‐Fu Chen, Peter Waiswa, Alex Ezeh, Catherine Kyobutungi, GM Leung, Cristiani Vieira Machado, Kabir Sheikh, Sam Watson, Jishnu Das

Bibliographic record

VenueThe Lancet Global Health · 2025
Typereview
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsCentre for Global Health Research
FundersMedical Research CouncilNational Institute for Health and Care Research
KeywordsService delivery frameworkLow and middle income countriesPrimary careBusinessLow incomeEconomic growthService (business)Developing countrySocioeconomicsMedicineEconomicsFamily medicineMarketing

Abstract

fetched live from OpenAlex

The landscape of primary care services in low-income and middle-income country cities is diverse and dynamic, yet the quality of care received is too often low and the financial cost to the patient high. In the second Paper in this Series, we argue that shaping the primary care market is likely to provide larger returns to scale than individual quality improvement initiatives. Among other things, the market can be shaped by regulation and targeted public investment to crowd out poor providers and motivate those that remain to improve. Additional supply-side initiatives for which there is evidence include measures to educate and motivate the workforce, skill substitution and formation of clinical primary care teams, information technology, and improving the supply of medicines and diagnostics. Demand-side measures include reducing out-of-pocket expenses and promoting health literacy and user advocacy. Research is urgently needed into access for people who are unregistered (eg, those who sleep on the streets), those in peri-urban areas and towns, and on cost-effectiveness, and sustainability of beneficial interventions.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.011
metaresearch head score (Gemma)0.016
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.022
Threshold uncertainty score0.063

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0110.016
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.003
Bibliometrics0.0050.007
Science and technology studies0.0010.002
Scholarly communication0.0030.003
Open science0.0020.002
Research integrity0.0040.005
Insufficient payload (model declined to judge)0.0080.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.041
GPT teacher head0.431
Teacher spread0.390 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations8
Published2025
Admission routes1
Has abstractyes

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