Advancing Patient Safety in Low-Resource Primary Health Care: A Narrative Review of Barriers and Strategies

Abstract

Patient safety in low-resource primary health care (PHC) remains an under-prioritized aspect of health system strengthening, despite its central role in reducing preventable harm and advancing universal health coverage. This narrative review synthesizes current evidence (2019–2025) to identify key barriers affecting patient safety in low-resource PHC settings and examine strategic approaches to address them. Major barriers include workforce shortages, weak safety culture, underreporting of adverse events, medication safety vulnerabilities, infrastructural limitations, and insufficient community health literacy. Strategic pathways emphasize strengthening leadership commitment, building non-punitive reporting systems, expanding workforce capacity, improving medication safety, adopting digital health innovations, engaging communities, and investing in essential diagnostic 
and infrastructure components. Addressing patient safety in low-resource PHC requires coordinated system-level and frontline interventions supported by policy alignment, adequate financing, and sustained capacity building.