Promoting primary care research

Research and evidence-based practices are crucial in South Asia’s family medicine and primary care practice

Promoting primary care research


ntegrating research and evidence-based practices into the training of family physicians and general practitioners is crucial. This will help them use the best available evidence for clinical decision-making. This contributes to a higher standard of care and encourages a culture of continuous learning and improvement within the healthcare system.

South Asia faces unique health challenges with the double burden of infectious diseases like tuberculosis, dengue fever and malaria, as well as non-communicable diseases such as diabetes and cardiovascular diseases. Research conducted within the South Asian region can provide valuable insights into these diseases, leading to the development of targeted interventions that are more relevant and effective for the local population. The evidence generated by research will help policymakers in decision-making and to develop and implement strategies that are effective and responsive to the needs of the local population. In South Asia, most of the countries fall into the LMIC category where health systems are often under-resourced and face numerous challenges due to financial constraints. These evidence-based policies are essential and will help in strengthening the health system and improving health outcomes.

In order to bring reforms in existing healthcare systems particularly primary healthcare systems in South Asian countries, an understanding of research, its application and practice of evidence base among family physicians/ general practitioners is critical. In our region, primary care training at both undergraduate and postgraduate levels is not fully established. As a result, the interpretation and use of clinical guidelines by primary care physicians remain poor. It is important to note that in the post-Flexner Report era where research became an essential component of curriculum worldwide, medical research failed to bloom in this region. However, the things are finally changing.

Even though most primary care physicians recognise the value of research, there are challenges in conducting research by family doctors in South Asia. Lack of support from the regulatory bodies and academic institutions, no formal mentorship or training, and no financial incentives and support are some of the obstacles that hinder their research efforts.

South Asia faces unique health challenges with the double burden of infectious diseases like tuberculosis, dengue fever and malaria, as well as non-communicable diseases such as diabetes and cardiovascular diseases.

About 10 years ago, isolated events during local and regional conferences in the form of workshops and sessions both face-to-face and online have taken place since 2013. Recently, more activities have happened in the region. The World Organisation of Family Doctors has become a network point as many like-minded FPs/ GPs have connected through it and carry out research projects in the region as groups. WONCA’s regional working group on research is more alive now with inputs from members from almost all South Asian countries. These activities could inspire more primary care physicians to engage in research.

A recent research project carried out by the working group examined the Barriers and Motivators Experienced by South Asian Primary Care Physicians in Conducting Research. It has many insights for anyone interested in promoting primary care research.

Some recommendations to increase research uptake by primary care physicians:

Identify ways to engage primary care professionals (general practitioners, family physicians) in research projects.

Offer research training at institutional levels

Promote understanding of the principles of research ethics as part of undergraduate and postgraduate training.

Encourage family medicine faculty to carry out original research work.

Encourage critical appraisal of literature and allow students to present their work at undergraduate levels.

To transform primary care synchronised efforts are required by multiple stakeholders including health organisations, health managers, healthcare professionals, degree awarding institutions and universities. Internationally and regionally a number of prominent figures over the years have helped shape primary care research. Their inputs are invaluable. Their work must be carried forward in the right direction and raised to a higher level. It’s time to not only invest in primary care but also to re-think the strategies to promote and strengthen it.

Dr Hina Jawaid is an associate professor in family medicine at Health Services Academy, Islamabad, Pakistan

Dr Abdul Jalil Khan, is the director of Institute of Family Medicine, Khyber Medical University, Peshawar, Pakistan

Dr Sankha Randenikumara, is a family physician in Sri Lanka and honorary secretary of WONCA-South Asia

Promoting primary care research