Defining public health transformation : a scoping review

Abstract

Public health transformation aims to instigate enduring changes in healthcare services, staff roles and patient involvement, fostering heightened satisfaction among patients and staff while bolstering financial sustainability. Public health transformation is the process of reorganizing and creating a shared vision to ensure the right mindsets, capacity, resources and workforce to deliver equitable Foundational Public Health Services and ultimately promote health, well-being and equity. Such transformation requires a fundamental change in public health systems’ structure, functioning and interactions, supported by continuous quality improvement, innovation, partnerships, community-driven efforts and systems change. This scoping review maps evidence of public health transformation. Searches encompassed databases including EBSCO Host, Academic Search Complete, Africa-Wide Information, Dentistry & Oral Sciences Source, Health Source–Consumer and Academic Edition, PUBMED and Scopus. Abstracts and full-text articles were screened by two independent reviewers against predefined criteria. Inclusion criteria spanned peer-reviewed published between 2013 and 2023. The quality of the included studies was assessed using the 2018 version of the mixed method appraisal tool. Screening results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. Of 9509 articles retrieved, 808 duplicates were excluded, leaving 8692 for title and abstract screening. Following title and abstract screening, 105 articles were relevant and underwent full article screening, which resulted in 20 that became eligible for data extraction. Emergent themes included (1) Transformation in Public Healthcare; (2) Evaluation of Health Transformation Programs; (3) Financial Implications; (4) Public Health Access; and (5) Job Satisfaction. Theme 4 featured a subtheme addressing healthcare access for minority groups. Overall, the review highlights a dearth of evidence guiding policymakers in decision-making on public health transformation, oversight of vulnerable populations, financial implications, and healthcare accessibility. Solutions should prioritize a people-centred approach in both practice and research to effectively address these gaps.