Lilford, Richard J;
Daniels, Benjamin;
McPake, Barbara;
Bhutta, Zulfiqar A;
Mash, Robert;
Griffiths, Frances;
Omigbodun, Akinyinka;
... Das, Jishnu; + view all
(2025)
Supply-side and demand-side factors affecting allopathic
primary care service delivery in low-income and middleincome country cities.
The Lancet Global Health
, 13
(5)
e942-e953.
10.1016/S2214-109X(24)00535-7.
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Abstract
Most people in low-income and middle-income countries (LMICs) now live in cities, as opposed to rural areas where access to care and provider choice is limited. Urban health-care provision is organised on very different patterns to those of rural care. We synthesise global evidence to show that health-care clinics are plentiful and easily accessible in LMIC cities and that they are seldom overcrowded. The costs that patients incur when they seek care are highly variable and driven mostly by drugs and diagnostics. We show that citizens have agency, often bypassing cheaper facilities to access preferred providers. Primary care service delivery in cities is thus best characterised as a market with a diverse range of private and public providers, where patients make active choices based on price, quality, and access. However, this market does not deliver high-quality consultations on average and does not provide continuity or integration of services for preventive care or long-term conditions. Since prices play a key role in accessing care, the most vulnerable groups of the urban population often remain unprotected.
| Type: | Article |
|---|---|
| Title: | Supply-side and demand-side factors affecting allopathic primary care service delivery in low-income and middleincome country cities |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/S2214-109X(24)00535-7 |
| Publisher version: | https://doi.org/10.1016/S2214-109X(24)00535-7 |
| Language: | English |
| Additional information: | © The Author(s), 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10209129 |
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