Barriers and gateways to adapt standards of the Health Promoting Hospitals: a rigorous consolidation of the global research evidence

Abstract

ABSTRACTThe Health Promoting Hospitals’ (HPH) initiative faces many challenges in practice to be implemented in diverse socio-economic and organizational settings. This systematic review was aimed to review empirical impeding factors and facilitators to pursuit the HPH standards. To provide a map of global research evidence on barriers and facilitators of adapting the HPH standards, several databases including PubMed, Embase and Scopus were searched using the relevant Medical Subject Headings (MeSH) for publications in June 1988 up to December 2018. The Socio Ecological Model (SEM) was employed to outline the pinpointed hurdles and supporting antecedents. Screening of the databases yielded 2,539 records of them 24 publications were eligible for inclusion and all were from developed countries. The most frequently reported facilitators were availability of resources, leadership and management support, intra health system collaboration/partnership and organizational capacity building for the HPH implementation. The most prevalent reported barriers were scarcity of resources, insufficiency of leadership and/or management support, paucity of skilled and informed/committed personnel, deficiency of evaluation programmes, not having health promoting approach amongst personnel, low priority of health promotion activities in hospitals and overall policy resistance to change. Based on the Socio Ecological Model’s (SEM) framework, the identified impeding and facilitating precedents could be scattered at all levels of the model i.e. individual to political strata. The identified challenges and compliances simply reflected the de facto situation in the developed countries to administer the HPH standards in traditional hospital settings.