World Organization Of Family Doctors Research Articles

Development, implementation, and evaluation of an undergraduate family medicine program in the United Arab Emirates

BackgroundHealthcare systems rely on well-trained family medicine physicians who can offer continuous quality services to their communities and beyond. The American Academy of Family Physicians and the World Organization of Family Doctors recommend that medical curricula should have adequately supervised education and training of the learners in family medicine during their preclinical and clinical placements. However, some medical schools don’t have a comprehensive family medicine program to prepare graduates who can meet the community needs. This work aims to report the essential steps for the development, implementation, and evaluation of the family medicine program at the College of Medicine at the University of Sharjah in United Arab Emirates.MethodsWe used the Kern’s 6-step model to describe the development, implementation, and evaluation of the family medicine program. This includes problem identification, needs assessment, goals setting, educational strategies, implementation, and evaluation. During 2014–2022, we longitudinally collected essential information about the family medicine program from different stakeholders including the feedback of clinical coordinators, adjunct clinical faculty, and medical students at the end-of-clerkship. All responses were analysed to determine the effective implementation and evaluation of the family medicine program.ResultsOver the course of 8 academic years, 804 medical students, 49 adjunct clinical faculty and three College of Medicine faculty participated in the evaluation of the family medicine program. The majority of respondents were satisfied with various aspects of the family medicine program, including the skills gained, the organisation of program, and the variety of clinical encounters. The medical students and adjunct clinical faculty suggested the inclusion of e-clinics, faculty development program, and the expansion of more clinical sites for the effectiveness of the family medicine program.ConclusionsWe report a successful development, implementation, and evaluation of the family medicine program in United Arab Emirates with a positive and impactful learning experience. More attention should be paid towards a suitable representation of family medicine program in the medical curriculum with focused and targeted educational plans for medical students.

The views of general practitioners in Morocco about health promotion at the primary health care services: Qualitative study.

Health promotion (HP) is one of the key skills that every general practitioner (GP) should have, according to The World Organization of Family Doctors, but for several reasons, his practice remains insufficient. However, a gap would exist between the GPs' knowledge and their practices about HP. The aims of our study were to explore GPs' perceptions, knowledge, and practices in Morocco about HP and identify their barriers and needs to best practice HP actions. A qualitative case study was conducted among GPs, via semi-structured interviews following an interview guide. Purposive and snowball sampling were used to select our sample. It contained four themes, perceptions, practices, barriers and needs, and proposals for improvement. The interviews were recorded and then transcribed. Thematic content data analysis was done manually. Favorable ethical approval was obtained from the local ethics committee. Fourteen GPs participated in this study. The sex ratio was at one. GPs' practices were focused on the biomedical model with wide confusion of HP with prevention and therapeutic education. Their roles in HP were considered paramount. The number of patients during consultations, structures' care, and knowledge were the main barriers. The main cited needs were material resources and HP training. Our study has made it possible to make an inventory of the practice of HP in Morocco. Participants' practices were based on the curative aspect. There is a crucial need to implement continuing and contextualized training for general practitioners to strengthen their skills in HP. This training will help to succeed in the health-promoting hospital's strategy.

30 by 2030 campaign

Primary Health Care (PHC) is a cornerstone of universal health coverage (UHC). To prevent diseases and holistically treat people, community-based primary healthcare systems need to be strengthened. PHC is an approach that aims to address physical, mental, and social health and well-being, and to provide comprehensive care for a person's health needs throughout life rather than focus on treating a specific set of diseases. To achieve this approach, we must strengthen horizontal PHC systems and encourage vertical programmes, including disease-specific programmes, to be developed, integrated, and implemented in the context of integrated Primary Health Care.
 In early 2020 the WHO Collaborating Centre on Family Medicine and Primary Health Care launched the 30by2030 campaign (https://www.30by2030.net), whereby signatories are asking donors of vertical disease-oriented projects to invest at least 30% of their budgets for vertical programs in strengthening coordinated and integrated primary health care. The initiative is a pull of efforts of different organizations such as Wonca: World Organisation of Family Doctors, The Network: Towards Unity for Health (TUFH), African Forum for Primary Health Care, European Forum for Primary Care, PRIMAFAMED network, among others.
 The 30 by 2030 has two aims: the first one is to inform and raise awareness of the impact of vertical programs on health systems. Most of the private and external funds, which represent one-third of the total spending of PHC, are channelled through programmes that focus on the health problems of specific population subgroups (e.g., HIV, tuberculosis, malaria) which also leads to inequity by disease. The second aim is to call for international donors to assign 30% of their vertical top-down, disease-oriented budgets to strengthen primary healthcare services through coordination, increased human resources and improved infrastructure.

The methodological and relational core competencies of General practice/Family medicine in Primary Care.

In this article, we examine three out of the seven distinctive values of General practice/family medicine (Gpfm), as proposed by World Organization of Family Doctors (Wonca) and recently translated into Italian: patient-centered care, continuity of care, and evidence-based care. We believe that these values can contribute to the ongoing debate on the reorganization of the primary care model and the reform of the core curriculum of Italian Gpfm. These three values are the basis of the distinctive methodological and relational competencies of Gpfm. In this contribution, we analyze them through the lens of epistemology of complexity, aiming to highlight the unique aspects of this method and relationship, thus identifying the necessary competencies for Gpfm. The thought and method of care - the first and third values - are analyzed considering that the framework in which Gpfm operates leads to significant modifications of the clinical method. While it certainly encompasses elements of the traditional clinical method, they are executed at different paces and with different objectives, employing distinct strategies. For instance, the epidemiological context with a high prevalence of symptomatic distress but low prevalence of "true" disease needs the early generation of diagnostic hypotheses. These hypotheses are then tested using verbal and physical examinations as exclusion tests with high predictive power. The aim is to arrive at diagnoses that are not exhaustive, yet operational and contextualized. Furthermore, the uncertainty inherent in Gpfm requires the utilization of contextual knowledge related to the patient's environment, negotiation with the patient about the tolerable threshold of decisional uncertainty, their involvement - which increases with greater uncertainty - and the use of the test of time within an organizational and relational protective network. Complex thinking enables reflection on the second value - the relationship - by assigning the physician's subjectivity a place as precious as that of the patient, which is already historically established. Thus, both the physician and patient, as subjects, exist on the same ontological plane but differ methodologically due to their distinct roles. Adopting an epistemology of complexity in Gpfm allows each variable of the system - subjects, context, method, clinical aspects - to regain significance. This approach favours a genuine science in service of humanity.

WONCA Europe 2023 Recommendations: Updated Definition of General Practice/Family Medicine Specialty, General Practitiner’s Competencies, Qualification Requirements for Academic Posts and Shortage of Primary Care Workforce Statement

Wonca Europe, the European branch of World Organization of Family Doctors, annualy holds a powerful international event – a conference for family doctors in Europe and the world, as well as a number of events on the eve. The objective: to analyze and highlight the news, documents and events of Wonca Europe 2023. Materials and methods. Own participation, observation and experience, analysis of documents and materials of Wonca Europe, materials of the Council meeting, analysis of information of Wonca and Wonca Europe websites, interviews of Wonca Europe members and conference participants. Results. 2,040 participants representing 75 countries from Europe and beyond took part in the Wonca Europe 2023 conference. At the Council meeting of Wonca Europe 2023, among delegates from 30 European countries participated with the right to vote were the president of the Ukrainian Association of Family Medicine, vice-rector, cor-member of NAMNU, Prof. O. K. Tolstanov and Prof. Tkachenko V. I. During the Council meeting the following important documents were approved: updated definition of medical and scientific specialty «General practice/family medicine» Wonca Europe (2023), characteristics of the discipline «general practice/family medicine», basic competencies of a general practitioner / family doctor, European qualification requirements for academic positions in general practice/family medicine in universities and academic departments. The program of the annual Wonca Europe conference included 9 keynote lectures, a number of workshops, many sessions with presentations of scientific research by family doctors, presentation of clinical cases from practice, short messages and 324 poster presentations. The WONCA Europe 2023 Statement in Shortage of European Primary Health Care Workforce became an important document with the aim of further presenting it to politicians and implementing it in European countries at the national level. Conclusions. The experience gained, founding documents and work experience will provide an impetus for further development, support and improvement of family medicine in Ukraine.

Development of Practice Guidelines for Peripartum Depression in Primary Healthcare

Abstract Background Antenatal and postpartum major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) is defined as either daily sustained sad mood or lack of enjoyment or desire for a minimum two weeks plus four associated manifestations (only three if the two major symptoms are present): 1) Unintentional notable slimming up or down; 2) Sleepiness or sleeplessness; 3)Tiredness sensation; 4) Guilty or futility sensation; 5) Declined concentration capacity; 6) Frequent suicidal thoughts or 7) Psychomotor excitation or delay, that start throughout pregnancy or during the first 4 weeks postpartum respectively. Objective To develop Egyptian practice guidelines for peripartum depression in Primary Healthcare (PHC). Methods The current study was conducted thorough Delphi technique by participation of Thirteen experts at psychiatry and family medicine specialties from different governmental universities, Ministry of Health and Population (MOHP), World Health Organization (WHO) and World Organization of Family Doctors (WONCA) via email thorough three consecutive phases of Delphi technique. Results The current study recommended health education programs, provision of awareness about physical exercise’s importance for prevention of antenatal and postnatal depression, adding telephone- based peer support for the preventive measures of the antenatal depression and family therapy for the postpartum depression prevention. Screening for all the pregnant women every trimester by patient health questionnaire II and screening for all the new mothers every well child clinic visit in the first year after delivery by Edinburg Postpartum Depression Scale (EPDS). Diagnosis by beck depression inventory II questionnaire and Postpartum Depression Screening Scale (PDSS) for antenatal and postnatal depression respectively with post diagnosis evaluation for: 1) Comorbid anxiety; 2) Bipolar disorder; 3) Thoughts of harming intrauterine fetus or newborns; 4) Suicidal thoughts and 5) Psychotic features. Cognitive Behavioral Therapy (CBT) for treatment of mild cases and CBT with half dose sertraline for moderate cases of antenatal depression. Cognitive Behavioral Therapy (CBT) for mild cases, CBT and the usual dose sertraline for moderate cases with no hormonal therapy for any patient. Referral for patients with: 1) severe depression; 2) comorbid anxiety; 3) bipolar disorder; 4) thoughts of harming intrauterine fetus or newborns; 5) suicidal thoughts; 6) psychotic features; 7) substance abuse. Conclusion development of Egyptian practice guidelines for peripartum depression in PHC. Wide dissemination of the practice guidelines to all the Egyptian PHC facilities via a suitable method and training programs for the family physicians on practicing these guidelines must be ensured.

Remodelling family medicine teaching at the University of Lausanne using a modified Delphi method

In the context of implementing a new framework for pre-graduate medical education in Switzerland (PROFILES) and the ongoing reform of the medical curriculum at the Faculty of Biology and Medicine of the University of Lausanne, we set out to determine the priority teaching themes of family medicine and to collect expert opinions about the most appropriate teaching methods for family medicine. Such data would contribute to the production of a coherent family medicine teaching programme encompassing its specificities as well as future challenges facing medicine in general. We mapped the current family medicine courses at the Faculty of Biology and Medicine to obtain an overview of current learning objectives and teaching content priorities. We classified and analysed the lessons using the PROFILES grid and the principles of family medicine described by the World Organization of Family Doctors (WONCA). Then we used a modified Delphi method with a selected panel of experts and two consensus rounds to prioritise objectives for family medicine teaching at the University of Lausanne. After choosing the top objectives/activities for family medicine, subgroups of experts then discussed what would be the best teaching methods for family medicine at the University of Lausanne. The mapping of family medicine teaching at the University of Lausanne showed that current teaching addresses most of the primary topics of family medicine education. The modified Delphi method allowed us to identify priority themes for teaching family medicine at the University of Lausanne: (1) take a medical history and clinical examination; (2) doctor-patient relationship / patient-centred care; (3) clinical reasoning; (4) interprofessional collaboration; (5) care planning/ documentation; (6) shared decision-making; (7) communication; (8) cost-effective care; (9) health promotion; (10) assessment of urgency. The discussion with the experts identified the strengths and weaknesses of the various teaching modalities in family medicine education. Teaching should be structured, coherent and show continuity. Clinical immersion and small group teaching were the preferred teaching modalities. This approach made it possible to create the guidelines for restructuring the family medicine teaching curriculum at the University of Lausanne.

Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases: consensus report of the joint Workshop by the European Federation of Periodontology (EFP) and the European arm of the World Organization of Family Doctors (WONCA Europe).

To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non-communicable diseases (NCDs) and promoting healthy lifestyles. The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings. Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID-19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centers and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals should be informed about the relevance of NCDs and the associated risk factors. Closer collaboration between oral health professionals and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated.

A Repository for Publications on Basic Occupational Health Services and Similar Health Care Innovations

BackgroundOccupational health services are not available for more than 80% of the global workforce. This pertains especially to informal workers, workers in agriculture and in small enterprises, and self-employed. Many are working in hazardous conditions. The World Health Organization, the International Labor Organization, the International Commission on Occupational Health, and the World Organization of Family Doctors promote as part of a solution, basic occupational health services (BOHS) integrated in primary or community health care. Quality information on this topic is difficult to find. The objective of this study is to develop an open access bibliography, a repository, referring to publications on BOHS and similar innovations, to support progress and research. MethodsThe database design and sustaining literature searches (PubMed, Google Scholar, SciELO) are described. For each publication selected, basic bibliographic data, a brief content description considering copyright restrictions, and a hyperlink are included. ResultsSearches resulted in a database containing 189 references to publications on BOHS such as articles in scientific journals, reports, policy documents, and abstracts of lectures. A global perspective is applied in 43 publications, a national or regional perspective is applied in 146 publications. Operational and evaluative research material is still scarce. Examples of references to publications are shown. ConclusionThe repository can inspire pioneers by showing practices in different countries and can be used for reviews and in-depth analyses. Missing publications such as from China, Russia, Japan, Republic of Korea, and Spanish/Portuguese speaking countries, can be added in the future, and translated. Search functions can be developed. International collaboration for the promotion of occupational health coverage for all workers must be intensified.

General practitioners' knowledge, attitudes and practices towards health promotion in Morocco.

Health promotion (HP) is a part of the general practitioners' (GPs) competencies defined by the World Organization of Family Doctors. The implementation of HP in their practice is unsatisfactory. The aim of this study was to explore GPs knowledge, attitudes and practices in Morocco about HP at the primary healthcare services. A cross-sectional study was conducted using an online self-administrated questionnaire including, knowledge, attitudes and practices of GPs toward HP. Descriptive and bivariate analyses were conducted. Two hundred and forty GPs responded to our questionnaires, the sex ratio was 1.12 with an average age of 40.46 ± 9.05 years. More than half of our participants perceived HP as a concept indistinct from prevention, 70.4% believed that HP refers to the biomedical model. On a Likert scale of 1-5, the level of HP knowledge was 2.71 ± 1.13. The most discussed topics with the population were tobacco, alcohol, overweight and obesity. Statistically significant association was found between the competencies of GPs in lifestyle behaviours and the practice of this competence. The knowledge of GPs remains insufficient, and their practices focus more on the areas in which they feel competent, which requires the implementation of specific training for the development of GPs skills in HP.

Ability and Preparedness of Family Physicians to Recognise and Treat Adolescent Mental Health Disorders in Nigeria and Ghana.

Management of mental health disorders has not been fully integrated into primary care despite been advocated by the World Health Organisation (WHO) and the World Organisation of Family Doctors (WONCA). This study therefore seeks to assess the ability and preparedness of Family Physicians to recognise and treat mental health disorders in adolescents. A descriptive cross-sectional study of 233 randomly selected Physicians Practicing in Family Medicine Clinics in Nigeria and Ghana was conducted using a semi structured self-administered questionnaire that was developed by the researchers and validated with a Cronbach's alpha coefficient of .85. Data analysis was done with the Statistical Package for Social Sciences™ (IBM Corp, Armonk, NY, USA) version 22.0. Respondents had a mean age of 43 ± 8 years, were mostly males 130 (55.79%), practised in Nigeria 168 (72.10%) and have been in practice for over 10 years 149 (63.95%). Majority of respondents 153 (65.67%) received at least one Medical Education sessions in mental health in the preceding 12 months of the study. Out of these, 146 (95.42%) said the sessions enhanced their knowledge of mental health, and 121 (79.08%) said the sessions enhanced their abilities and preparedness to attend to patients with mental disorders. Barriers included stigmatisation 156 (66.95%), poor facilities 136 (58.37%), non-conducive environment 135 (57.94%) and non-cooperation from patients 133 (57.08%). This study showed that a lot of family physicians in Ghana and Nigeria are able and prepared to manage adolescent mental health disorders. They however cited stigmatisation, poor facilities and non-conducive environment as barriers to management of adolescent mental health disorders in primary care. Considering the severity of the disorder, there is a need to increase the training of Family Physicians in the management of adolescent mental health.

Planetary health action framework: A case study

Planetary Health (PH) action is urgent to avoid the collapse of Earth's systems that sustain human health. PH care has been proposed as an approach to improve health equity and reduce healthcare´s ecological footprint. This paper presents the conceptual framework of patient-centered PH care as essential for PH action at the community level. We examine and reflect on one primary care clinical case through 8 lenses: 1) Actor-Network Theory, 2) Evidence-based medicine, 3) Patient-Centered Clinical Method; 4) Principles of Primary Care, 5) Proposed new primary care derivate principle of PH care, 6) the WONCA´s (World Organization of Family Doctors) core competencies tree, 7) WONCA´'s curriculum, and 8) Sustainable Development Goal 3. This case offers insights into functions of primary care that mitigate, adapt and build resilience to the challenges of climate emergency and Anthropocene. It “connects-the-dots” to propose a new identity of primary care, elaborate a blueprint for patient-centered PH care and a roadmap for PH action at the community level.

Proposal to set up a College of Family Medicine in East, Central and Southern Africa.

Family Medicine training in Africa is constrained by limited postgraduate educational resources and opportunities. Specialist training programmes in surgery, anaesthetics, internal medicine, paediatrics and others have developed a range of trainers and assessors through colleges across East, Central and Southern Africa (ECSA). Each college has a single curriculum with standardised training and assessment in designated institutions, which run alongside and in collaboration with the Master’s in Medicine programmes in universities. Partnerships between colleges in Britain, Ireland and Canada and national specialist associations have led to joint training-of-trainer courses, e-learning platforms, improved regional coordination, better educational networking and research opportunities through regional conferences and joint publications. We propose the establishment of a regional college for specialist training of family physicians, similar to other specialist colleges in ECSA. Partnerships with family medicine programmes in South Africa, Canada and Australia, with support from international institutions such as the Primary Care and Family Medicine Network for Sub-Saharan Africa (PRIMAFAMED) and the World Organisation of Family Doctors (WONCA Africa), would be essential for its success. Improved health outcomes have been demonstrated with strong primary care systems and related to the number of family physicians in communities. A single regional college would make better use of resources available for training, assessment and accreditation and strengthen international and regional partnerships. Family medicine training in Africa could benefit from the experience of specialist colleges in the ECSA region to accelerate training of a critical mass of family physicians. This will raise the profile of family medicine in Africa and contribute to improved quality of primary care and clinical services in district hospitals.

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe.

BackgroundThe Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs.AimThis study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians.MethodsAn anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs.ResultsTwenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration.Lessons learntThis study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.Keywordsfamily medicine; primary care; medical education; global health; community medicine.

Improving Primary Health Care Data With ICPC-3: From a Medical to a Person-Centered Perspective.

The World Organization of Family Doctors (WONCA) developed the third edition of the International Classification of Primary Care (ICPC-3) to support the shift from a medical perspective to a person-centered perspective in primary health care. The previous editions (ICPC-1 and ICPC-2) allowed description of 3 important elements of health care encounters: the reason for the encounter, the diagnosis and/or health problem, and the process of care. The ICPC-3 adds function-related information as a fourth element, thereby capturing most parts of the encounter in a single practical and concise classification. ICPC-3 thus has the potential to give more insight on patients' activities and functioning, supporting physicians in shifting from a strict medical/disease-based approach to care to a more person-centered approach. The ICPC-3 is also expanded with a new chapter for visits pertaining to immunizations and for coding of special screening examinations and public health promotion; in addition, it contains classes for programs related to reported conditions (eg, a cardiovascular program, a heart failure program) and can accommodate relevant national or regional classes. Classes are selected based on what is truly and frequently occurring in daily practice. Each class has its own codes. Less frequently used concepts pertaining to morbidity are captured as inclusions within the main classes. Implementation of the ICPC-3 in an electronic health record allows provision of meaningful feedback to primary care, and supports the exchange of information within teams and between primary and secondary care. It also gives policy makers and funders insight into what is happening in primary care and thus has the potential to improve provision of care.

The APEC Digital Hub-WONCA Collaborative Framework on Integration of Mental Health into Primary Care in the Asia Pacific.

Mental ill health affects individual well-being and national economic prosperity and makes up a substantial portion of the burden of disease globally, especially in the Asia-Pacific region. Integrating mental health into primary care is widely considered a key strategy to improve access to mental health care. Integration, however, is a complex process that needs to be addressed at multiple levels. A collaboration between the Asia-Pacific Economic Cooperation (APEC) Digital Hub for Mental Health and the World Organization of Family Doctors (WONCA) is described in this paper, which outlines a framework and next steps to improve the mental health of communities in APEC economies. This paper notes gaps related to the integration of mental health into primary care across the region and identifies enablers and current best practices from several APEC economies. The potential of digital technology to benefit primary mental health care for populations in the APEC region, including delivery of training programs for healthcare staff and access to resources for patients, is described. Finally, key next steps are proposed to promote enhanced integration into primary care and improve mental health care throughout the APEC region.

COVID-19 and international primary care systems: Rebuilding a stronger primary care.

In this BJGP Open collection, we examine how international primary care systems have performed in response to COVID-19. The past few months have seen rapid change and adaption of primary care systems to meet unprecedented new challenges. The pandemic has also exposed critical weaknesses in systems all over the world.1 The World Health Organization (WHO) and the World Organization of Family Doctors (WONCA) contend that an ideal primary care system should fulfil the core characteristics laid out by Barbara Starfield:2 primary care should be accessible, affordable, available at the time of need, and represent the ‘front-door’ to the health system. It should provide ongoing care and coordination with other specialists and focus on individuals and their families beyond their biological disease.3,4 The Astana Declaration5 and the WHO Vision for Primary Health Care in the 21st Century 6 also make a case for empanelment (working for a listed or geographically defined population) and a model of primary care that is engaged with …

What do psychiatrists think about primary mental health competencies among family doctors? A WPA-WONCA global survey.

People with common mental disorders often seek medical attention from their family doctors. Thus, it is essential for family doctors to possess primary mental health knowledge. The aim of this study was to understand whether psychiatrists endorse the primary mental health competencies identified by the World Organization of Family Doctors and whether they agree that family doctors are demonstrating these competencies. A questionnaire was constructed based on 32 core competencies. Presidents of all World Psychiatric Association member societies were invited to complete the questionnaire or to forward it to local experts. According to the respondents, these competencies are considered relevant yet not sufficiently possessed by typical primary care doctors. Proposals are made to bridge this assumed competency gap.

Knowledge and attitude of primary care physicians towards obstructive sleep apnea in the Middle East and North Africa region.

Sleep disorders are highly prevalent in primary care. Obstructive sleep apnea (OSA) is one of the most common sleep disorders in the world, and it is estimated that only 10 to 20% of OSA cases are diagnosed. Primary care physicians (PCP) play an important role in screening for OSA. Knowledge of sleep disorders among PCP varies widely and has been generally reported as low. In this study, we aimed to assess the knowledge and attitudes towards OSA among primary care physicians in the Middle East and North Africa regions. A cross-sectional study using the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) self-administered questionnaire was distributed to PCP attending the Lebanese Society of Family Medicine annual conference, the Lebanese Society of Internal Medicine annual conference, and World Organization of Family Doctors (WONCA) East Mediterranean region conference. Of 300 physicians approached, 256 (85%) completed the questionnaires. The range of possible scores was 0 to 18. The mean total knowledge score with standard deviation (SD) was 12.6 (2.5). Internal medicine specialists showed a higher mean knowledge score of 14.1 (2.3) compared to general/family medicine specialists 12.4 (2.4) and other specialties 11.9 (2.8), p = 0.001. Though 78% of all physicians felt confident in identifying patients with OSA, only 26% felt confident in managing patients with continuous positive airway pressure. Overall, there was a weak positive correlation between knowledge and attitude. There were gaps in knowledge and attitudes regarding managing patients with OSA. Training in managing patients with OSA is needed.

Exploring gaps, strategies and solutions for primary care research mentorship in the African context: A workshop report.

BackgroundPrimary care needs research to generate evidence relevant to community needs; however, there is a lack of research engagement among primary care physicians, especially in sub-Saharan Africa. Improved research mentorship for family physicians (FPs) can help address prevailing knowledge and practice gaps in primary care research.Workshop processDuring the 6th annual Africa Regional Conference of the World Organization of Family Doctors (WONCA), we conducted three workshops on research mentorship for African FPs. Two workshops (one online and one onsite at the pre-conference) were geared towards the young doctors’ movement of WONCA Africa. The third was onsite during the main conference. Following a brief presentation on the concept of research mentorship and known gaps, participants broke into small groups and discussed additional gaps, solutions and anticipated readiness for implementing these solutions. We used a content analysis to summarise key concepts and had participants to review the findings.Workshop findingsIdentified gaps related to mentees’ difficulty initiating and maintaining mentorship relationships and an overall shortage of capable and willing mentors. Organisational solutions focused on capacity building and creating a culture of mentorship. Interpersonal solutions focused on reducing the power distance and increasing reflectivity and feedback. Increasing the use of research networks and both peer and online mentorship were advocated. Barriers to readiness included resource constraints and competing priorities.ConclusionA multi-level approach is needed to address the gaps in research mentorship for African FPs. Identified solutions hold potential for supporting the research engagement needed to improve the population health across Africa.