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Abstract Background The effectiveness of eLearning in enhancing healthcare professionals’ capacity has received substantial attention globally. This review sought to synthesis evidence on the effectiveness of various types of eLearning programmes, and the facilitators and barriers to its use. Methods The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four main databases (PubMed, Web of Science, JSTOR, and Scopus) in July 2023 and 44 articles met the eligibility criteria and were included in the review. The JBI critical appraisal checklist was used to appraise the methodological quality of the studies. The data were examined using narrative review to determine the effectiveness of the intervention as well as the barriers and facilitators to its use. Results This review found that asynchronous, synchronous, blended, and self-learning methodologies are effective eLearning approaches for continuous professional development. Previous positive experiences, user-friendly interfaces and relevance of the eLearning content to daily practice are critical elements that facilitate eLearning usage. Poor computer competence and literacy, lack of personal computers and high family duties were the main personal factors that hindered eLearning use. Some systemic barriers included; heavy workloads, shortage of specialised eLearning facilitators poor management involvement, and technical inadequacies within the ICT departments. Environmental issues such as poor infrastructure, including limited internet and frequent power outages acted as barriers. Conclusion The review highlights the effectiveness of various eLearning approaches among health professionals and presents the disparities between developing and developed economies in relation to the facilitators and barriers.

Background: The inverse care law states that the availability of good healthcare tends to vary inversely with the need for it in the population served. This situation is easily observable in developing countries like Nigeria, and poses a threat to the attainment of universal health coverage (UHC) in rural communities. Objective: To examine how the inverse care law plays out in the Nigerian healthcare system, and how this may lead to a difficulty in achieving UHC in rural communities. Materials and Methods: Standard procedures were used in locating, selecting, extracting and synthesizing data. Electronic databases and internet resources such as PubMed, Google Scholar, SCOPUS and Web of Science were searched. Selection of studies was conducted by a two-stage process. Data extraction was done using data extraction forms. During data synthesis, major themes, strengths, weaknesses and critical gaps in each paper were identified. Results: There are several factors that boost the operation of the inverse care law in the Nigerian healthcare system. How this poses a threat to the attainment of UHC has also been documented. Among these are limitations in the range of services provided in rural healthcare facilities, inadequate production and maldistribution of health personnel, and low health manpower retention in rural areas. Conclusion: There is a need for concerted efforts by the government to address the factors that facilitate the inverse care law in the Nigerian healthcare system. This is necessary for the attainment of UHC specifically and the Sustainable Development Goal number three generally.

Health system responsiveness reflects the extent national health systems meet the legitimate expectations of patients. This study assessed the responsiveness of primary health care services in Nigeria from the clients’ perspective. A cross-sectional survey of 379 participants were randomly selected from 7 centers from a sample frame of 20 primary healthcare centers. Descriptive results were presented in frequencies and percentages. The associations between the importance and performance ranking were examined using the Spearman’s ranked correlation coefficient. Multivariate logistic regression was used to identify predictors of responsiveness with p-values ≤ 0.05 considered statistically significant. There were equal proportion of respondents aged≥30 years but more were female (95%), had attained less than the tertiary level of schooling (60.9%), and currently married (92.3%). The highest proportion of patients reported good responsiveness for dignity (81.8%) and least proportion for the choice of care provider (53.8%). Patient-level predictors of good responsiveness in relation to autonomy were younger age (p = 0.003) attainment of tertiary level of education (p = 0.001); tertiary education was associated with confidentiality (p = 0.009) and those who are not married with prompt attention (p = 0.027). Dignity, confidentiality, and prompt attention were identified as priority areas to focus in improving the responsiveness of primary healthcare services in Rivers State. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens.