Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jul 18;4(3):e70081.
doi: 10.1002/puh2.70081. eCollection 2025 Sep.

Factors Influencing Primary Healthcare System in the Achievement of Universal Health Coverage in the WHO-AFRO Region: An Integrative Review

Emmanuel O Adesuyi  1   2 , Opeoluwa O Olabode  2   3 , Oluwatosin C Olarinde  2   4 , Blessed O Oyama  2 , Inioluwa O Aderemi  2   5 , Gloria O Alao  2 , Bose C Ogunlowo  2   6
Affiliations
Review

Factors Influencing Primary Healthcare System in the Achievement of Universal Health Coverage in the WHO-AFRO Region: An Integrative Review

Emmanuel O Adesuyi et al. Public Health Chall. .

Abstract

Background: The primary health centres are designed to be the first line of contact with the public and the main target for achieving universal health coverage (UHC). However, despite global advancements in healthcare, Africa continues to face unacceptably high health outcome indices, underscoring the significant challenges in achieving UHC. This review synthesises evidence on the factors influencing the primary healthcare system, focusing on its role in achieving UHC within the WHO-Afro region.

Methods: This is an integrative literature review. An extensive and systematic search for eligible literature was performed in eight databases between 2000 and 2024, including APA PsycINFO, CINAHL, Medline, Scopus, EmCare, Embase, Ovid Nursing and Gale Academic One File. The articles identified were critically appraised. A narrative synthesis of evidence was done to fully explore the review question. The findings were presented using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in-line with EQUATOR guidelines.

Result: Overall, 26 studies were included in the review. Six themes captured the factors influencing the PHC system in the achievement of UHC: (1) physical access to critical services, (2) availability of resources, (3) sociodemographic and cultural factors, (4) access to data and health information, (5) legislation and policy and (6) quality of care.

Conclusion: This review highlights interconnected factors necessitating a holistic approach to optimising PHC effectiveness and driving progress towards achieving UHC. Integrating human, financial and infrastructural resources alongside community-driven strategies, equitable digital technologies and robust policy frameworks is essential to improving health outcomes and achieving UHC.

Keywords: WHO‐Afro; primary health centre; universal health coverage.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart of review result (2000–2024).
See this image and copyright information in PMC

References

    1. World Health Organisation , “Section IV—Health Impact,” WHO AFRO iAHO, 2025, https://aho.afro.who.int/atlas‐health‐impact/af?lang=pt.
    1. Worldometer , “Life Expectancy by Country and in the World (2025)—Worldometer,” 2024, https://www.worldometers.info/demographics/life‐expectancy/.
    1. World Health Organisation , “World Bank and WHO: Half the World Lacks Access to Essential Health Services, 100 Million Still Pushed Into Extreme Poverty Because of Health Expenses,” 2017, https://www.who.int/news/item/13‐12‐2017‐world‐bank‐and‐who‐half‐the‐wor....
    1. World Health Organisation , “Primary Health Care,” 2023, https://www.who.int/news‐room/fact‐sheets/detail/primary‐health‐care.
    1. Zhao Z., Dong S., Wang J., and Jiang Q., “Estimating the Efficiency of Primary Health Care Services and Its Determinants: Evidence From Provincial Panel Data in China,” Frontiers in Public Health 11 (2023): 1173197, 10.3389/fpubh.2023.1173197. - DOI - PMC - PubMed

LinkOut - more resources