Table 1

General characteristics of included studies (N=484)

CharacteristicsN (%)
EMR countries in which the studies were conducted
 Saudi Arabia143 (29.5)
 Iran65 (13.4)
 Jordan35 (7.2)
 Egypt34 (7)
 Bahrain33 (6.8)
 Lebanon26 (5.4)
 Tunisia24 (5)
 United Arab Emirates21 (4.3)
 Kuwait15 (3.1)
 Palestine15 (3.1)
 Qatar14 (2.9)
 Oman14 (2.9)
 Iraq12 (2.5)
 Morocco11 (2.3)
 Sudan8 (1.7)
 Algeria3 (0.6)
 Syria2 (0.4)
 Yemen2 (0.4)
 Comoros0 (0)
 Djibouti0 (0)
 Libya0 (0)
 Mauritania0 (0)
 Somalia0 (0)
 Two or more EMR countries7 (1.4)
Country of the institution to which the first author is affiliated
 EMR countries421 (87)
 Non-EMR countries63 (13)
Country of the institution to which the contact author is affiliated
 EMR countries400 (82.6)
 Non-EMR countries79 (16.3)
 Not reported5 (1)
Study designs
 Cross-sectional273 (56.4)
 Chart/retrospective document review63 (13.0)
 Mixed methods31 (6.4)
 Qualitative30 (6.2)
 Randomised controlled trial15 (3.1)
 Case report14 (2.9)
 Cohort11 (2.3)
 Literature review11 (2.2)
 Quasi-experimental9 (1.9)
 Systematic review2 (0.4)
 Case–control1 (0.2)
 Other24 (5.0)
Descriptive vs effectiveness studies
 Descriptive studies423 (87.4)
 Effectiveness/intervention studies61 (12.6)
Language of publication
 English463 (95.7)
 French21 (4.3)
Dimensions and themes pertaining to quality, safety and performance management *
Input 85 (17.6)
 Resource availability51 (10.5)
 Facility environment28 (5.8)
 Preferences and culture19 (3.9)
Service delivery 446 (92.1)
 Provider competence260 (53.7)
 Performance measurement and management168 (34.7)
 Trainings71 (14.7)
 Patient–provider relationship49 (10.1)
 Gatekeeping and referrals45 (9.3)
 Patient safety39 (8.1)
 Access37 (7.6)
 Provider motivation26 (5.4)
 Team work and leadership22 (4.5)
 Information system use22 (4.5)
 Comprehensiveness22 (4.5)
 Community engagement and outreach16 (3.3)
 PHC reforms14 (2.9)
 Person-centred13 (2.7)
 Provider safety13 (2.7)
Outcome 219 (45.2)
 Clinical outcomes100 (20.7)
 Patient satisfaction64 (13.2)
 Service utilisation41 (8.5)
 Provider satisfaction22 (4.5)
 Patient reported outcomes15 (3.1)
 Coverage14 (2.9)
 Knowledge/practice of patients10 (2.1)
 Efficiency9 (1.9)
 Equity9 (1.9)
 Costs8 (1.7)
  • *The percentages do not add to 100 as some articles included more than one dimension and theme.

  • EMR, Eastern Mediterranean Region; PHC, primary healthcare.