Assessment of the Primary Health Care Process in the Kurdistan Region of Iraq: A focused review

Abstract

There is an urgent need to restructure and improve the primary health care system in the Kurdistan Region of Iraq as part of broader health system reforms. However, there is a significant gap in the literature, as few publications provide a comprehensive and structured analysis of the challenges, needs, and opportunities within this system. Therefore, this review addresses this gap by assessing the primary care process component, identifying key barriers, and highlighting opportunities for improvement. There are significant impediments to primary care delivery. Inappropriate service delivery is primarily due to the irrational use of services, poor referral systems, and irrational treatment. Easy accessibility and almost free-of-charge service delivery are the main features of the access dimension. However, these features frequently result in overutilization and affordability concerns due to the lack of all required services and the reliance on the private sector. The lack of a well-established family medicine system and the inability of people to have a doctor are considered impediments to proper longitudinal continuity of care. The ineffective referral system is a common problem in the current primary care system for the coordination of care. In terms of the comprehensiveness dimension, the primary health care system provides a wide range of primary care services, including preventive and curative health services, but is inadequate in some areas. Strengthening the primary care process requires establishing a robust family medicine system, improving referral mechanisms, and promoting rational service use to enhance continuity, coordination, and comprehensiveness of care.