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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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.754
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0040.000
Bibliometrics0.0000.002
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0010.002
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0000.000

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 teacher head, not a consensus.

Study designSystematic review
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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