Organisation of primary health care in the Asia-Pacific region: developing a prioritised research agenda

Palagyi, Anna; Dodd, Rebecca; Jan, Stephen; Nambiar, Devaki; Joshi, Rohina; Tian, Maoyi; Abimbola, Seye; Peiris, David

lImITATIonS We adopted a pragmatic approach to incorporate stakeholder views in the analysis of knowledge gaps and expand on the systematic review reported by Dodd and colleagues. 22 The research team made every effort to recruit a broadly based panel for the Delphi exercise, resulting in a group of 22 experts from seven countries (as listed in table 1), with 14 original panel members completing rounds 2 and 3. We were therefore limited by the small Delphi panel size (only 22/179 (13%) invited participants agreed to join and 14/22 (64%) original panel members completed rounds 2 and 3). The initial response rate is reflective of response rates previously achieved by web-based Delphi research, 24 and is a notable drawback of this virtual method of engagement that should be considered alongside benefits of efficiency and geographical reach. We were thus unable to highlight regional variation in priority evidence needs and reliably determine the areas of concordance and discordance between the literature-informed evidence gaps and stakeholder research priorities. The inability to include China stakeholders represents a significant limitation, particularly given the predominance of evidence from China PHC systems. Alternative approaches to engaging China PHC stakeholders in priority setting activities, including roundtable discussions or the face-to-face nominal group technique, are proposed in the future. Lack of expert panel representation from Pacific Island countries in the latter stages of the Delphi process also weakens the geographic relevance of identified research priorities. Clearly, the findings would need to be corroborated with both deeper engagement with panel members (perhaps through in-depth interviews) and broader engagement with a larger number of stakeholders from across the region.