Global Health and Primary Care Research

Abstract

A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in primary care is essential to inform practice and to develop better health systems and health policies. Among the challenges for primary care, especially in countries with limited resources, is the need to enhance the research capacity and to engage primary care clinicians in the research enterprise. These caregivers need to be an integral part of the research enterprise so the right questions will be asked, the results from research will be used in practice, and a scholarly and evidence-based approach to primary care will become the norm.The challenge of developing research in primary care can be met only by creating a strong infrastructure. This will include strengthening academic departments, enhancing links to researchers in other fields, improving training programs for future primary care researchers, developing more practicebased primary care research networks, and increasing funding for research in primary care. A greatly increased commitment on the part of international organizations both within and outside of primary care is needed, in particular those organizations involved with funding research. We provide suggestions to improve the global primary care research enterprise for the benefit of the world's population. A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and in resource-poor countries. To improve equity in health it is vitally important to improve health services for the world's poorest and least healthy people.1 Among the challenges for developing a strong primary care system, especially in countries with limited resources, is that of developing research capacity in primary care. This capacity is needed to inform practice and to improve health systems and policies. This paper reviews the evidence supporting the role of the primary care system in providing effective and efficient health care, the need for primary care research to be part of this system, a description of the primary care research, and recommendations to strengthen the primary care research enterprise. The Strength of Primary Care Predicts a Population's Health StatusStudies of the value of health services have concluded that approximately half of the improvements in the health of populations in the past half century are attributable to health services, with other factors (geography, nutrition, public health measures) accounting for the remainder.2-4 Within the last 2 decades, several researchers have shown that the strength of the primary care component of health systems is positively related to most common indicators of population health status, including birth outcomes, potential years of life lost, ageadjusted death rates, and age-specific mortality rates. The benef...

Primary care research: does it defy definition?

“…However, when trying to classify the topics we were reviewing, we needed to modify the classification. While most authors writing on this topic admit that the categories proposed are overlapping (Mold and Green, 2000;Beasley et al, 2007), we found no clear categories for areas commonly researched such as health-seeking behavior, screening, and other prevention activities.…”

“…Mash (2014: 2) [drawing from Beasley et al (2007)], writing specifically for an African context, summarizes five categories:…”

“…The positive influence of a country's primary care system on the health of its people has been repeatedly demonstrated (Starfield and Shi, 2002;Macinko et al, 2003;Starfield et al, 2005;Beasley et al, 2007), though mostly in industrialized countries. Since each country's primary care needs vary based on the country's epidemiology, local research must be done in order to design, implement, and evaluate primary care in each country.…”

Understanding of family medicine in Africa: a qualitative study of leaders’ views

“…This is supported by the World Health Assembly. 2 While strong primary health care is essential to provide efficient and effective health care in both resource-rich and resource-poor countries, 3 the role of family medicine cannot be assumed to be the same everywhere. There have been renewed efforts globally to define the principles and practice of family medicine, 4 for example, the European definition of general practice in 2002, the future of family medicine in the US in 2004, and the future of general practice in the UK in 2007, as well as operational definitions of attributes of primary health care in Canada.…”

Nutrition and self-care practices of patients with chronic Metabolic Syndrome: a qualitative study

“…There are also recommendations for interdisciplinary clinical practice for MS, combining contributions from different fields of knowledge in the development of specific actions for the treatment and broader public policies (5,6) . Several authors agree that it is possible to reduce the risk for severe cardiovascular events and even suspend the continuous use of some medications if individuals give up smoking, lead a less sedentary life, along with following a balanced diet.…”