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    Review of 'Primary care in Caribbean Small Island Developing States'

    Primary care in Caribbean Small Island Developing StatesCrossref
    It is necessary to define the variables considered in this paper.
    Average rating:
        Rated 3 of 5.
    Level of importance:
        Rated 4 of 5.
    Level of validity:
        Rated 3 of 5.
    Level of completeness:
        Rated 2 of 5.
    Level of comprehensibility:
        Rated 2 of 5.
    Competing interests:

    Reviewed article

    • Record: found
    • Abstract: found
    • Article: found
    Is Open Access

    Primary care in Caribbean Small Island Developing States

    Abstract Caribbean Small Island Developing States (SIDS) made good process on improving the health of their populations; but concerns exist when it comes to meeting changing health needs. Due to remoteness and limited resources it is difficult to respond to high rates of non-communicable diseases (NCDs). Furthermore, little is known about how primary care (PC) is organised and how this responds to current health issues. This study focused on gaining insights in the organisation of PC of Caribbean SIDS based on currently available literature. This literature review was an explorative multiple case study, where structure of PC and health status of 16 Caribbean SIDS were reviewed using available scientific and grey literature between the years 1997 and 2014. Thirty documents were used to analyse 20 indicators for the dimensions “Structure of Primary Care” and “Health Status”. Results were mapped in order to identify if there is a possible relation between structures of PC to the health of the populations. When reviewing the structure of PC, the majority of information was available for “Economic conditions of PC” (78%) and the least information was available for “Governance of PC” (40%). With regards to health status, all islands show improvements on “Life expectancy at birth” since 2007. In contrast, on average, the mortality due to NCDs did not improve. Saint Lucia performs best on “Structure of PC”. The British Virgin Islands have the best health status. When both dimensions were analysed, Saint Lucia performs best. There is still little known on the responsiveness of PC of Caribbean SIDS to NCDs. There is a need for elaborate research on: (1) If and how the functioning of these health systems relate to the health status; (2) What islands can learn from an analysis over time and what they can learn from cross-island analysis; and (3) Filling the gaps of knowledge which currently exist within this field of research.

      Review information

      This work has been published open access under Creative Commons Attribution License CC BY 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com.

      Caribbean region,health care systems,small island developing states,non-communicable disease,Primary care

      Review text

      Major Suggestions

      The manuscript does not define all variables nor the methodology used to calculate the indicators. Without this information, it is not possible to cite this paper. At the very least, I suggest adding more information on the variables, "Economic conditions", "Governance of PC”, "PC workforce", "Health of population”, and "Structure of PC”.

      Along the above lines, in the abstract, it is cited that there are improvements in “life expectancy at birth" since 2007; but, the actual paper does not provide an evolution along time in a simple table or graph.

      Minor Suggestions

      Consider consulting an English native speaker. For example, on page 3, “put into” in the sentence, "Results of reviewed literature were put into a matrix in order to get insight which indicators were retrieved”, should be changed to “organized in”. Additionally, the second paragraph of the section, “Data Representation” is not very clear, and it should be rewritten. What were the authors trying to communicate here?

      In the first paragraph of page 4, explain how to correct for missing data. Probably the averages are weigthed according to the amount of missing data and this must be written in the methodology.

      In the first paragraph of the section “Workforce PC”, the authors state that “PC health centres offer services to an average of 5100 people”. Is that daily? weekly? monthly? In the same paragraph, the sentence beginning, “Examples the type of…” should be rewritten: “Examples of types of disciplines…”.

      Lastly, here is an additional reference which could help...

      Published by the World Bank in 2015: Toward Universal Health Coverage and Equity in Latin America and the Caribbean: Evidence from Selected Countries at http://dx.doi.org/10.1596/978-1-4648-0454-0


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