Impact of nursing interventions on the implementation of primary health care policies: A Systematic Review

Awatiful Azza; Zusana  A. Sasarari; Etty Komariah Sambas; A. Wardah Muzfah

doi:10.61099/junedik.v3i3.144

Authors

Awatiful Azza Faculty of Health Sciences, Universitas Muhammadiyah Jember, East Java, Indonesia
Zusana A. Sasarari Department of Nursing, Universitas Cendrawasih, Papua, Indonesia
Etty Komariah Sambas Department of Nursing, Universitas Bakti Tunas Husada, West Java, Indonesia
A. Wardah Muzfah Universitas Andi Sudirman, South Sulawesi, Indonesia

DOI:

https://doi.org/10.61099/junedik.v3i3.144

Keywords:

Community empowerment, Health policy, Nursing interventions, Primary health care

Abstract

Introduction: Primary health care (PHC) is recognized as the foundation of equitable and sustainable health systems. Nursing interventions are essential in translating PHC principles into effective practice. However, limited synthesized evidence exists on the effectiveness of nursing-led initiatives within PHC policy frameworks. This review aimed to evaluate the impact of nursing interventions on the implementation of PHC policies, with the hypothesis that structured nursing interventions enhance health outcomes, policy adherence, and community engagement.

Methods: Following the PRISMA guidelines, a systematic search was conducted across PubMed, CINAHL, Scopus, and Cochrane Library for studies published between 2010 and 2025. Eligible studies included randomized controlled trials, quasi-experimental, and observational designs assessing nursing-led interventions in PHC settings. Two reviewers independently performed data extraction and quality appraisal. Due to methodological heterogeneity, a narrative synthesis was employed.

Results: A total of studies demonstrated that nursing interventions such as health education, chronic disease management, maternal-child health support, and community empowerment significantly improved service accessibility, patient satisfaction, and adherence to PHC policy objectives. Moreover, community-based nursing initiatives strengthened preventive care delivery and promoted equity in service utilization.

Conclusion: The findings confirm that nurses are pivotal in operationalizing PHC policies. Strengthening nursing capacity through training, policy integration, and resource allocation can accelerate progress toward universal health coverage. Further research is needed to establish standardized evaluation frameworks and measure long-term policy impacts of nursing interventions in PHC systems.

Downloads

Download data is not yet available.

References

Atkins, B., Maden, M., Birt, L., Tromans, S., Swithenbank, Z., Kersey, O. R., Smith, P., & Scott, S. (2025). Primary care healthcare professionals supporting patients to discontinue antidepressants: A scoping review of barriers, enablers and interventions. Research in Social and Administrative Pharmacy, 21(6), 431–443. https://doi.org/10.1016/j.sapharm.2025.02.004

Clement David-Olawade, A., Olawade, D. B., Ojo, I. O., Famujimi, M. E., Olawumi, T. T., & Esan, D. T. (2024). Nursing in the Digital Age: Harnessing telemedicine for enhanced patient care. Informatics and Health, 1(2), 100–110. https://doi.org/10.1016/j.infoh.2024.07.003

Cordova, D., Bauermeister, J. A., Warner, S., Wells, P., MacLeod, J., Neilands, T. B., Mendoza Lua, F., Delva, J., Fessler, K. B., Smith Jr, V., Khreizat, S., & Boyer, C. (2024). Efficacy of a Digital Health Preventive Intervention for Adolescents With HIV or Sexually Transmitted Infections and Substance Use Disorder: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 13, e47216. https://doi.org/10.2196/47216

Dawson, A., Lyons (Jaadwa), L., Morey, K., Pearson, O., Harfield, S., Brand (Eastern Arrente), T., DeMasi (Barkindji), K., Mulholland (Torres Strait Islands – ERUB), E., Aromataris, E., Braunack-Mayer, A., & Brown (Yuin), A. (2025). Ways of working in Aboriginal and Torres Strait Islander Community Controlled Health Organisations: describing a conceptual model of comprehensive primary healthcare characteristics. Australian and New Zealand Journal of Public Health, 49(4), 100267. https://doi.org/10.1016/j.anzjph.2025.100267

DuBois, S., Spencer, A., Nava, A., Kaminski, M., Gonzalez, A. L., & Arensberg, M. B. (2025). Nourish the mind: the need for nutrition-focused education in nursing to improve health outcomes. Journal of Professional Nursing. https://doi.org/10.1016/j.profnurs.2025.08.002

Eltaybani, S., Anezaki, S., Fukui, C., Igarashi, A., Sakka, M., Noguchi-Watanabe, M., Inagaki-Asano, A., Kojima, T., & Yamamoto-Mitani, N. (2025). Association between home-visit nursing use and the occurrence of unfavorable health outcomes among community-dwelling older adults: A prospective cohort study. Geriatric Nursing, 63, 661–669. https://doi.org/10.1016/j.gerinurse.2025.04.010

Ghanem Atalla, A. D., Mahmoud Elseesy, N. A., El-Ashry, A. M., Sobhi Mohamed, S. M., Felemban, E. M., Alharbi, A., Saied Gheith, N. A., & Mahmoud khalifa khattab, S. (2025). Unveiling the hidden connection: Investigating the relationship between shared leadership and missed nursing care. International Journal of Nursing Sciences, 12(1), 12–18. https://doi.org/10.1016/j.ijnss.2024.12.012

Hashmi, F. A., Burger, O., Goldwater, M. B., Johnson, T., Mondal, S., Singh, P., & Legare, C. H. (2023). Integrating Human-Centered Design and Social Science Research to Improve Service-Delivery and Empower Community Health Workers: Lessons from Project RISE. She Ji: The Journal of Design, Economics, and Innovation, 9(4), 489–517. https://doi.org/10.1016/j.sheji.2024.02.001

Jassemi, S., Sparkes, D., Delgado, M., Harwood, L., Bello, A. K., Beanlands, H., Elliott, M., McBrien, K., Gil, S., Straus, S., Hemmelgarn, B., & Donald, M. (2025). Implementation and Evaluation of a Patient-Focused eHealth Intervention, My Kidneys My Health, in Primary Care and General Nephrology Clinics: Multimethods Study. Journal of Medical Internet Research, 27, e71832–e71832. https://doi.org/10.2196/71832

Kovacevic, R. M., Behrens, D. A., & Hyll, W. (2024). Nursing interventions in a newly established community health nursing system: A cross sectional survey. International Journal of Nursing Studies Advances, 7, 100258. https://doi.org/10.1016/j.ijnsa.2024.100258

Li, B. (2025). Uncovering the influence of community nursing on health promotion in China: A biopower analysis. Social Science & Medicine, 372, 117964. https://doi.org/10.1016/j.socscimed.2025.117964

Li, Y., Kpokiri, E., Elasi, D., Sheng, R., Wang, K., Conyers, H., Zhang, Y., Adda, D. K., Matthews, P. C., Fitzpatrick, T., Tucker, J. D., & Wu, D. (2025). Community engagement and chronic viral hepatitis public health interventions: a systematic review, meta-analysis, and complementary crowdsourcing open call. EClinicalMedicine, 83, 103234. https://doi.org/10.1016/j.eclinm.2025.103234

Long, J., Zhang, S., Chu, L., Balkian, J., Giovannucci, I., Mui, C., Luan, Y., Chang, O., Chanthavilay, P., Goundar, K., Luvsan, M.-E., Kennedy, E., Nguyen, D., Ann Phoa, P. K., Ramirez, C. M., Tran, B. X., Yi, S., Valera, P. M., Tep, S., … Lu, C. (2025). Policies, resource allocation, and interventions for child and adolescent mental health in low- and middle-income countries in the Western Pacific Region: a scoping review. The Lancet Regional Health - Western Pacific, 101674. https://doi.org/10.1016/j.lanwpc.2025.101674

Lu, F., Wong, C. K. H., Ng, A. P. P., Li, L., Fong, D. Y. T., Ip, P., Tse, E. T. Y., & Lam, C. L. K. (2024). Effectiveness of a 5-year health empowerment programme on promoting cardiovascular health for adults from low-income families in Hong Kong. Patient Education and Counseling, 124, 108240. https://doi.org/10.1016/j.pec.2024.108240

Mezzalira, E., Canzan, F., Marini, G., Longhini, J., Leardini, C., Saiani, L., & Ambrosi, E. (2024). Introduction of novel complex integrated care models supported by digital health interventions in European primary settings: a scoping review. Health Policy and Technology, 13(4), 100896. https://doi.org/10.1016/j.hlpt.2024.100896

Padhani, Z. A., Rahim, K. A., Avery, J. C., Tessema, G. A., Castleton, P., Nisa, S., Damabi, N. M., Boyle, J. A., Salam, R. A., Meherali, S., & Lassi, Z. S. (2025). Preconception care interventions among adolescents and young adults to prevent adverse maternal, perinatal and child health outcomes: An evidence gap map. Public Health, 239, 37–47. https://doi.org/10.1016/j.puhe.2024.12.036

Patrick, R., Noy, S., McKew, M., Lee, S., Kanda, M., Edwards, S. J., Ali, A., & Bowen, K. (2025). Rapid review on healthy ageing interventions that incorporate action on climate change and sustainability in cities and communities. Health & Place, 93, 103435. https://doi.org/10.1016/j.healthplace.2025.103435

Prinja, S., Purohit, N., Kaur, N., Rajapaksa, L., Sarker, M., Zaidi, R., Bennett, S., & Rao, K. D. (2024). The state of primary health care in south Asia. The Lancet Global Health, 12(10), e1693–e1705. https://doi.org/10.1016/S2214-109X(24)00119-0

Ramayanti, I., Prameswarie, T., Ghiffari, A., & Alpasyah, M. M. (2025). Chemical Factors in Clothes Wastewater Affect the Development of Aedes aegypti Mosquitoes. Majalah Kesehatan Indonesia, 6(1), 1–8. https://doi.org/10.47679/makein.2025223

Rudel, R. K., Kaufmann, N. D., Burrowes, S. A. B., Harding, C., Solomon, C., Linas, B. P., Drainoni, M.-L., & Barnett, K. G. (2025). Harnessing storytelling with medical students and community members to build curiosity and trust: A mixed methods evaluation of a pilot intervention. PEC Innovation, 7, 100420. https://doi.org/10.1016/j.pecinn.2025.100420

Shrestha, P., Afsana, K., Weerasinghe, M. C., Perry, H. B., Joshi, H., Rana, N., Memon, Z. A., Khaled, N., Malhotra, S., Bhardwaj, S., Kafle, S., Inagaki, Y., Schimdt, A., Hodgins, S., Neupane, D., & Rao, K. D. (2024). Strengthening primary health care through community health workers in South Asia. The Lancet Regional Health - Southeast Asia, 28, 100463. https://doi.org/10.1016/j.lansea.2024.100463

Soares, S., Hoffmeister, L. V., Fernandes, M. de F., Henriques, A., & Costa, A. (2024). The Use of Digital Technologies in the Promotion of Health Literacy and Empowerment of Informal Caregivers: Scoping Review. JMIR Aging, 7, e54913. https://doi.org/10.2196/54913

Strus, J. A., Sankam, J., Green, S., Piper, M., Richards, S., Knowles, K., North, K., & Solomonian, L. (2025). Adaptation and mitigation for the planetary health crisis: A scoping review from the perspective of primary health care providers. The Journal of Climate Change and Health, 22, 100440. https://doi.org/10.1016/j.joclim.2025.100440

Suprapto, Kamaruddin, M. I., Herlianty, & Nurhanifah, D. (2024). Building Nurse Competency Strategy at Public Health Center in Indonesia: A Descriptive Qualitative Approach. The Malaysian Journal of Nursing, 15(03), 62–70. https://doi.org/10.31674/mjn.2024.v15i03.008

Thawnarain, A., & Downing, C. (2025). Nursing students’ caring practices in caring for LGBTQIA+ patients in a hospital setting. Nurse Education Today, 153, 106792. https://doi.org/10.1016/j.nedt.2025.106792

Wijayanti, Y. T., Nurhanifah, D., Asmi, A. S., Suprapto, S., Rahagia, R., & Millati, R. (2025). Perception of Nursing Students on Clinical Teaching and Learning of Public Health Nurses: A Descriptive Qualitative Approach. Malaysian Journal of Nursing, 16(04), 142–151. https://doi.org/10.31674/mjn.2025.v16i04.014

Yeh, M.-Y., Wu, S.-M., & Che, H.-L. (2024). Level of empowerment of hospitalized patient in Taiwan clinical practice. Journal of the Formosan Medical Association, 123(11), 1139–1143. https://doi.org/10.1016/j.jfma.2024.07.007

Zhang, A., Zhou, C., Wang, S., Yuan, Y., Zhang, S., Hu, H., & Wang, Y. (2025). Community Health Empowerment in the Chinese Cultural Context: A Hybrid Concept Analysis. Asian Nursing Research, 19(3), 203–219. https://doi.org/10.1016/j.anr.2025.03.012