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June 1, 2026Frontiers in Public HealthOpen Access

Understanding pathways from primary health care to universal health coverage outcomes: a realist review

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Authors

NCNeymat ChadhaDNDevaki NambiarSSSharmada Sivaram

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Overview

Realist review explores how primary health care reforms impact universal health coverage outcomes across contexts, highlighting barriers and facilitators.

Key Points

  • This review aims to understand how primary health care (PHC) reforms influence universal health coverage (UHC) outcomes in differing contexts.
  • Conducted a realist review using 42 studies from countries with significant UHC Service Coverage Index gains from 2000 to 2021.
  • Studies underwent blinded screening, appraisal, and data extraction for quality assessment.
  • Data synthesized through iterative development of configurations linking PHC mechanisms and UHC outcomes.
  • Identified two key configurations: one focusing on reproductive, maternal, newborn, and child health, and another on overall PHC design.
  • Reforms emphasized service expansion, benefit package design, and financing initiatives but faced barriers in reaching marginalized groups.
  • PHC reforms contributed to improved coverage and financial protection but struggled with effective service quality.

Cite This Study

Chadha et al. (2026) studied this question.

synapsesocial.com/papers/6a1d20bc02fbce9130636ff2https://doi.org/10.3389/fpubh.2026.1808891
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Also Consider

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  4. 4Primary health care–oriented reforms: the political economy dynamics underlying health-system shifts across nine countries2026
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