Barriers and facilitators in experiences of Community Oriented Primary Care (COPC) in Latin America: Exploratory Systematic Review.

Abstract

Introduction: Community Oriented Primary Care emerged between the 1940s and 1950s in Pholela, South Africa, seeking to improve the living conditions of communities under the social medicine practice model. This concept was developed over the years into what is known as Primary Health Care. Methodology: Under an exploratory systematic review, an analysis of the publications from 1978 to 2020 in Latin America is carried out, exploring some relevant elements that the literature indicates as conditions for the identification of characteristics that facilitate or hinder the development of (APOC) models. 232 were managed after duplicates, 46 reviewed and included 28 that met the inclusion criteria, being carried out in Latin American populations, which alluded to COPC between the years 1978 and 2020. Results: Facilitators of COPC are identified in the literature: community participation, academic environment, care based on needs, coverage in all phases of the disease, health responsibility in a defined population. The articulation with the academic environment emerged as a preponderant facilitator in the exploratory systematic review. Among the barriers was a lack of political will, irrational use of resources, and fragmentation of health services. Discussion: The integration between public health and primary care is essential to achieve changes in the health of the community, APOC achieves that objective of integrating them. The community is receptive to COPC when it comes to solving their problems. Conclusion: It is necessary to implement APOC models in countries whose regulations encourage the development of PHC-based systems and support research from academia to achieve the participation of all the actors in the health system of each region.