Document Type : Original Article


1 Department of Healthcare Management, Semnan Branch, Islamic Azad University, Semnan, Iran

2 Governance and Health Research Group, Neuroscience Research Institute, Tehran University of Medical Sciences and Health Services, Tehran, Iran Leadership and Governance Scientific Group, Health Managers Development Institute, Ministry of Health and Medical Education, Tehran, Iran

3 Healthcare Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Epidemiology and Biostatistics, Mazandaran University of Medical Sciences, Sari, Iran


Clinical governance is a systematic approach to enhancing the quality of primary health care and
ensuring high clinical standards, responsiveness to performance, and continuous improvement
in service quality. The objective of the current study was to investigate the global experiences
of clinical governance in primary health care. In the present systematic review, relevant articles
from different countries were searched in various databases such as MD PubMed from Medline
portal, Emerald Springer link, ProQuest, Cochrane, Scopus, Web of Science, and Consult until
April 2019. The searched articles were checked through CASP and PRISMA checklists, and their
results were extracted. Of the 17 selected studies, 16 belonged to developed countries, including
England (13), Australia, Italy, and New Zealand, and one was from Turkey. The findings were divided
into three general categories: (1) principles of effectiveness and risk management, (2) deployment
requirements such as structural and organizational needs, resource and communication, and
information management, and (3) barriers of clinical governance toward providing primary health
care. it is recommended that a suitable framework or model be developed and designed adapted
to the local culture and taking into account all effective dimensions for a proper establishment and
implementation of clinical governance in primary health care.


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