Successes, weaknesses, and recommendations to strengthen primary health care: a scoping review

Table 2 Barriers of primary health care

Barriers	Countries
Leadership
Poor infrastructure	Haiti [118] and Australia [119]
Poor organisation	Brazil [115]
Political and legal issue	Brazil [120]
Health Financing
High out-of-pocket payment	Brazil [55, 121, 122], Australia [123], New Zealand [124]
Absence of health insurance	Saudi Arabia [125]
Poor remuneration system	China [114]
Delayed funds	Kenya [48]
Health workforce
Lack of adequate staff	Canada [95, 96, 126,127,128], Brazil, China, Poland, Australia [72, 114, 129, 130], Belgium [88, 131], Nigeria [49]
Lack of training	Australia [119, 132]
Lack of clear job descriptions	Australia [119], UK [51] and South Africa [133]
Unfair health worker distribution	Ethiopia [134]
Service delivery
Absence of quality of circle	Multicounty [135]
Language carrier	Canada [95, 96, 126,127,128], Saudi Arabia [29], USA [136, 137]
Lack of tools or guidelines	Multicounty [138], developing countries [9, 139], in Brazil [55, 121, 122], Italy [47], Kenya [48]
Weak client engagement	Australia [119]
Lack of family support	Nigeria [66, 140]
Client and physician factor
Discriminatory perception	Sweden [141]
Poor service hours	Nigeria [66, 140]
PHC services coincidence with market days	Nigeria [66, 140]
Varied perception between clients and providers	South Africa [103]
Attitude of indigenous community	Canada [95, 96, 126,127,128]
Community’s lack of trust to health service	Australia [129]

ISSN: 2049-3258