Education for primary health care in Africa.

No abstract available.

Family doctors' roles and perceptions on antibiotic consumption and antibiotic resistance in Romania: a qualitative study.

BACKGROUND: Antimicrobial resistance (AMR) is a major global health issue, bringing significant health burden and costs to societies. Increased antibiotic consumption (ABC) is linked to AMR emergence. Some of the known drivers of ABC are antibiotics over-prescription by physicians and their misuse by patients. Family doctors are recognised as important stakeholders in the control of ABC as they prescribe antibiotics and are considered a reliable source of medical information by patients. Therefore, it is important to explore their perceptions, especially in Romania, which has the highest ABC among European Union Member States. Furthermore, there is no published research exploring Romanian family doctors' perceptions regarding this phenomenon. METHODS: This was a qualitative study with data collection via semi-structured interviews among 12 family doctors. Manifest and latent content analysis was used to gain an in-depth understanding of their perceptions. Findings were mapped onto the domains of the Behaviour Change Wheel to facilitate a theory driven systematization and analysis. RESULTS: Two main subthemes emerged: i) factors affecting ABC and prescribing and ii) potential interventions to tackle ABC and antibiotic resistance. The factors were further grouped in those that related to the perceived behaviour of family doctors or patients as well as those that had to do with the various systems, local contexts and the COVID-19 pandemic. An overarching theme: 'family doctors in Romania see their role differently when it comes to antibiotic resistance and perceive the lack of patient education or awareness as one of the major drivers of ABC' was articulated. The main findings suggested that the perceived factors span across the capability, opportunity and motivational domains of the behaviour change wheel and could be addressed through a variety of interventions - some identified by the participants. Findings can also be viewed through cultural lenses which shed further light on the family doctor- patient dynamic when it comes to antibiotics use. CONCLUSION: Potential interventions to tackle identified factors emerged, revolving mostly on efforts to educate patients or the public. This exploratory research provides key perspectives and facilitates further research on potential interventions to successfully address AMR in Romania or similar settings.

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).

AIM: 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. MATERIALS AND METHODS: 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. RESULTS: 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 centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors. CONCLUSIONS: Closer collaboration between OHPs 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.

Public policy changes in public funding of family doctors in Slovenia

In Slovenia, patients report difficulties registering with a family doctor (FD), even in dense urban areas, since the patient-to-FD ratio is well below the EU average and not improving. Moreover, public primary healthcare providers (PCP) report difficulties with the financial liquidity that endangers the regular payment of employed FDs' salaries and constantly call for additional budget funding in the healthcare sector, especially after the COVID-19 pandemic crisis. It is therefore questionable, whether or not the PCP, which perform economic activity under the EU standards, respect human rights of all the stakeholders in the healthcare sector. Therefore, in this paper, I analyse the existing regulations on the public financing of FDs in Slovenia that seems to pose significant problems to patients' timely access to health care and does not facilitate the FDs' goal of delivering the patients' constitutional right to healthcare services. I discuss some better alternative solutions that would promote the patients' right to effective primary healthcare, attract more medical students to specialise in family medicine and consolidate the fiscal sustainability of the primary healthcare sector, which is at grave risk of collapse due to a dysfunctional healthcare payment and delivery system. Copyright © 2022 Inderscience Enterprises Ltd.

Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors.

Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods: We conducted a cross-sectional online survey of all family doctors in the Hong Kong College of Family Physicians between June and July 2021. Their practice of making COVID-19 recommendation to patients was assessed. Based on the Health Belief Model, factors associated with doctors' recommendation practices were explored and examined. Multivariate logistic regression models were used to investigate the factors, including COVID-19 vaccine attributes, associated with doctors' practices in making recommendations. Their own vaccination status and psychological antecedents to vaccine hesitancy were measured. Results: A total of 312 family doctors responded (a 17.6% response rate). The proportion of doctors who had received COVID-19 vaccines was 90.1%. The proportion of doctors who would recommend all patients without contraindications for the vaccination was 64.4%. The proportion of doctors who would proactively discuss COVID-19 vaccines with patients was 52.9%. Multivariate logistic regression analysis showed that doctors' own COVID-19 vaccination status was the strongest predictor of family doctors making a recommendation to patients (aOR 12.23 95% CI 3.45-43.33). Longer duration of practice, willingness to initiate the relevant discussion with patients and less worry about vaccine side effects on chronic illness patients were the other factors associated with making a COVID-19 vaccination recommendation. Conclusions: Family doctors should be encouraged to get vaccinated themselves and initiate discussions with patients about COVID-19 vaccines. Vaccine safety data on patients with chronic illness, training and guidelines for junior doctors may facilitate the COVID-19 vaccination recommendation practices of family doctors.

The boy's painting (Spain): Thanking health workers during COVID-19 pandemic.

Unlike most countries in the world, Spain has a unique and huge system of highly specialized out-of-hospital emergency service, led by the best trained family doctors, specialists in Emergency Medicine. While the ambulance went down the street at 20th with sirens and music to cheer on the people of city Ibiza, Balearic Islands, Spain, on April 7, 2020, a BOY approached unsurely, under the supportive and complicit eyes of the people from the balconies and without saying a word passed the ambulance health workers, his drawing through the window.

A Statement of Solidarity on COVID-19 Pandemic 2020 by the South Asian Family Physicians.

The World Organization of Family Doctors (WONCA) is a not-for-profit organization and was founded in 1972 by member organizations in 18 countries. WONCA now has 118 Member Organizations in 131 countries and territories with a membership of about 500,000 family doctors and more than 90 percent of the world's population. WONCA has seven regions, each of which has its own regional Council and run their own regional activities including conferences. WONCA South Asia Region is constituted by the national academies and colleges and academic member organizations of this region namely India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives. In the background of the ongoing COVID 19 pandemic, the office bearers, academic leaders, practitioners, and researchers of primary care from the South Asia Region have issued a solidarity statement articulating the role of primary care physicians.