Context, Delivery Models, and Healthcare Outcomes of Community-Oriented Primary Care Services in Cuba: A Systematic Review of Narrative Evidence Protocol

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Abstract

Objective

This systematic review aims to summarize narratives related to the context, delivery models, and healthcare outcomes associated with Community-Oriented Primary Care (COPC) services provided by Cuban primary care practitioners to local community residents.

Introduction

“Community orientation” is a core feature of primary health care that enhances population health and a vital skill for general practitioners. COPC integrates primary health care and community medicine in a coordinated practice to improve population health. Cuba stands out globally, particularly among low- and middle-income countries, for its primary health care system and has achieved outstanding population health outcomes through this approach. However, systematic evidence summarizing the context, delivery models, and healthcare outcomes of COPC in Cuba remains lacking.

Inclusion and Exclusion Criteria

Included documents must: (1) focus on Cuban primary care practitioners and teams delivering community-oriented primary care services, along with local residents receiving and participating in these services; (2) explicitly address COPC services, including their context, delivery models, and healthcare outcomes; (3) be set in the Cuban community or primary care context; (4) consist of published or unpublished narratives within grey literature; (5) be in Spanish or English; and (6) be published on or after January 1, 1990. Excluded literature: (1) does not explicitly mention COPC services provided by Cuban practitioners, their context, or healthcare outcomes; (2) only addresses context beyond local health administration and community influence (e.g., U.S. economic embargo); (3) only involves events outside the Cuban primary care context (e.g., international medical missions); (4) is not a narrative (e.g., quantitative or qualitative studies).

Methods

We will search narrative literature published between January 1, 1990, and July 31, 2024, in Spanish or English across four academic databases: PubMed, Web of Science, Google Scholar, and Embase, and grey literature from the World Health Organization (WHO), the World Organization of Family Doctors (WONCA), including its Latin American branches, and the Cuban Ministry of Public Health websites. The review protocol is developed using JBI SUMARI. Qualified researchers will screen literature using Rayyan and JBI SUMARI, assess methodological quality, and extract data with JBI SUMARI tools. Data will be synthesized via the meta-aggregation method in JBI SUMARI.

Systematic Review Registration Number

This study is registered with PROSPERO, registration number is: CRD420251018485.

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