Authors: Fadumo Abdi Noor, Gabriel Gulis, Jens Søndergaard
Abstract:Aims: This literature review aims to get an overview on terminology and recent knowledge of application of multilevel approach in public health. The multilevel principle consists of systems and processes acting on micro, meso and macro level. Method: We conducted a review of published literature using PubMed, EmBase and Web of Science and we extended our search to include grey zone literature. We choose to focus our literature review on articles that described the multilevel principle and public health and collaboration between public health and primary care. We reviewed abstracts and our search yielded a final total of 74 articles we retained 31 of them and eliminated articles that were not related explicitly to the subject Results: Our search identified various activities through which multilevel approach could contribute to more effective action in health systems, as well as functions usually performed by primary care that seem to be related to population health approach. Most authors identified screening and immunizations as actions that are carried out in meso level (primary care), but can benefit from the support macro level (state regulations). Activities related to public health are surveillance of population health and acting on determinants (micro, meso and macro level). The main areas of overlap found in the literature between these sectors are health surveillance, health promotion and prevention of disease and injury. Conclusion: Our literature review identified that application of multilevel approach to increase population health and improve the health care system could be enhanced by public health and primary care collaboration.
Keywords: public health, multilevel approach, health promotion, collaboration, integration