The Besrour Centre for Global family Medicine 2022: A Year in review
Welcome to our Global Family Medicine Community
Reflections from Dr. Lawrence C. Loh and Dr. David Ponka:Three years on, the COVID-19 pandemic continues to exert enormous pressure on the health of populations around the world. Economic difficulties, crises in accessing health care, and social disruption symptomatic of a polycrisis—one that can only be addressed by multiple sectors working together—have all had impacts on physical and mental health.The Besrour Centre was created amid a different disaster, one that befell Haiti in 2010. At that time a massive earthquake resulted in the loss of life and infrastructure, which was then compounded by waves of infectious disease, mental health issues, and a breakdown of the social fabric that holds communities together, from which the people of Haiti are still recovering to this day. These times of intense and sustained stress, however, remind us of our interdependence and the limits of siloed thinking—both domestically and globally—as well as the fundamental human need for reciprocity in understanding and addressing the needs of others. We are also reminded of the important work of family medicine and primary care in creating meaningful and productive connections in communities and across health systems—including partners in public health and mental health. Family physicians and family health modes are positioned at the heart of health systems. We invite you to read on to learn about how we are working with colleagues from around the world to advance the discipline of family medicine here and in other contexts through our work in research, education, and collaboration. The world needs more primary care and family medicine, and global problems require more global partnerships and solutions. The Besrour Centre for Global Family Medicine wants to hear from you and work collectively for the health of all.
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About the Besrour Centre for Global Family MedicineFor nearly 20 years the Besrour Centre for Global Family Medicine (Besrour Centre) at the College of Family Physicians of Canada (CFPC) has been both fueling and learning from family medicine innovations around the world.The Besrour Centre, which leads global health initiatives undertaken by the CFPC, is driven by family physicians with a passion for global health. The Besrour Centre is an international hub of collaborators and knowledge sharers dedicated to advancing family medicine and promoting health equity for better health around the world. Localized approaches to family medicine can be an effective model to address global public health issues with globally adopted solutions. The Besrour Centre serves as an important resource to learn from our primary care colleagues who work in challenging settings around the globe. The Besrour Centre brings lessons learned, relevant examples of academic and practice-based innovation, and inspiring stories of efficient use of community resources to improve patient care to the global community. Our tools to drive advancements are based in advocating for family medicine and team-based care, building capacity in medical education and training around the world, strengthening worldwide partnerships, and driving research and quality improvement. The ongoing impact and fallout of the global COVID-19 pandemic continues to reinforce the importance of improving care through diversity of roles within family medicine and primary care and better integration with public health, other specialties, and community members and groups.  Our vision is to lead the way in creating a world where no one is left behind when it comes to accessing quality primary care  Our mission is to foster collaboration to advance family medicine around the world  Our values guide our commitment to equity, justice, excellence, reciprocity, and respect as we strive to build stronger health systems and better health for all |
Connect with us!If you are interested in learning more about global health or how lessons and innovations from our family medicine partners can help you improve your practice here in Canada, we would love to hear from you.Please email us at [email protected]. You can also support our work by donating through the Foundation for Advancing Family Medicine (FAFM) and select the Besrour Centre to direct funds. |
Advancing global family medicine and primary care together
 In global health, no single organization, group, or nation has sufficient resources. The needs and inequities are vast. To drive change, we need to come together to advocate for family medicine’s central role in care planning and delivery, leverage what is already in place, synchronize efforts, and amplify what is working.After the disruption of the pandemic, last year was a time to: 
Local partnerships for global impactOne of the Besrour Centre’s major strengths is that we work within the CFPC, a well-respected, bilingual organization that has a strong tradition of academic family medicine in Canada.In our mission to advance family medicine around the world, we work to leverage the efforts of Canadian departments of family medicine in their overseas outreach. Two areas of advancement in 2022:
Promoting social accountability and health equity in the FrancophonieCanada’s bilingual context allows the Besrour Centre to forge effective partnerships with organizations across the French-speaking world, furthering efforts to advance social accountability and health equity.In November 2022 a number of universities, faculties of medicine, and French health networks gathered for Scientific Francophone Day at the XVIIIe Sommet de la Francophonie in Djerba, Tunisia. A key outcome of the event was the Declaration of Djerba: Establishing a Partnership for Health Equity in the Francophonie, in which partners identified five strategic directions to support equitable access to health care in the Francophonie. Declaration of Djerba: Establishing a Partnership for Health Equity in the Francophonie
The Scientific Francophone Day was the result of a working group established earlier in 2022 with the goal of forming a partnership and network among francophone faculties of medicine and health sciences to improve health outcomes in underserved and vulnerable communities. This group continues to work together to establish frameworks according to the strategic priorities of the Declaration of Djerba and identify other opportunities to strengthen the Francophonie.
Family Medicine Forum 2022Once again, the Besrour Centre was a key participant at the annual Family Medicine Forum (FMF). Our focus for every FMF is to share lessons from outside Canada about efficient use of resources, concrete examples of academic and practice innovations, and interdisciplinary collaboration to deliver care in complex jurisdictions.
In 2022 we had the pleasure of hosting international delegates from Indonesia, Madagascar, Argentina, Uganda, and Saudi Arabia. These international delegates had the opportunity to attend inspiring keynote sessions and access best evidence-based education sessions and networking opportunities, including a visit to a family health team in downtown Toronto, Ontario. It also offered Canadian delegates a chance to learn from international colleagues working in varying contexts.   
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Research
| Robust research enables the practice of family medicine to grow and improve the health of people around the world. The pandemic and these dynamic times have provided a unique backdrop for collaboration, innovation, and advancements. The Besrour Centre focuses specifically on enabling family medicine research and quality improvement by:  Identifying and addressing the knowledge gaps of our partners  Building research capacity  Creating and disseminating relevant knowledge to our partners and networks |
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FM Vax
Initially launched in 2021 FM Vax: An international survey on the integration of public health and primary care in COVID-19 vaccination campaigns set out to understand the primary health care approach used by different countries in implementing their vaccination programs for COVID-19.
Impact in 2022:-
Publication of the study protocol in the African Journal of Primary Care and Family Medicine
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Data collection completed and analysis under way with 477 valid responses from 84 countries. See FM Vax: Preliminary Results infographic for early results.
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Presentation of the preliminary results at the Seventh Global Symposium on Health Systems Research in Bogota, Colombia; at the Family Medicine Forum 2022 in Toronto, Ontario; and virtually at the Primary Health Care Research Consortium webinar series: Making Comprehensive Primary Health Care a Reality in Low- and Middle-Income Countries (LMICs)
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Global Family Medicine Mapping
Although family medicine has existed for decades, it is a novel and emerging discipline in many countries. The training and scope of practice of family physicians differs around the world and is not well understood. The aim of the Global Family Medicine web page is to provide a broad overview on family medicine in different regions and countries.
With a generous allocation of funds from the FAFM Trailblazers program, the Besrour Centre is aiming to advance this project by:-
Collecting and updating data on length and type of training, density, and roles of family physicians (e.g., as leaders within teams, gatekeeper), organization of family medicine through professional associations, and the integration with public health and other specialties
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Exploring data using an ontological approach to be able to draw lessons about particular strengths of family medicine/primary care from different contexts
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Optimizing the website for it to be a useful tool for family physicians and health care leaders. Mapping and visual display of information permits users to quickly identify differences between contexts.
This analysis of family medicine around the world expands our understanding of family medicine training at the country level, describing the evolution of the discipline. While no one pathway guarantees success, this process permits us to identify best practices across contexts to, for example, understand how to improve and/or expand residency training.
Map representing length of family medicine residency in countries around the world.
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Research Awards
Dr. Patrick Chege Memorial Research Award at FMF 2022
Dr. Patrick Chege was a family physician who led the development of family medicine in Kenya. In 2008 he became one of the first family medicine trained physicians in Kenya. He founded the Kenya Association of Family Physicians and began serving as the Head of the Family Medicine Department at Moi University in Eldoret, Kenya in 2012. Dr. Chege was a highly regarded member of the Besrour community.Initiated in 2017 the annual poster session celebrates global collaboration with an intent to inspire vibrant dialogue among FMF participants. The name was changed in 2021 to honour Dr. Patrick Chege, a colleague who passed away from COVID-19 in the early days of the pandemic.
The scientific committee adjudicated 19 research posters altogether, with the winners as follows:
Best poster: “Step-wise evolution of partnership Memorandums of Understanding in the building of Family Medicine Capacity in Guyana.”
Congratulations to primary presenter Dr. Tamica Daniels-Williamson (Georgetown Public Hospital Corporation in collaboration with the University of Guyana. Georgetown, Guyana)
Second-place poster: “Awareness, Availability and Use of Teaching Aids in Family Medicine Training Centres in West Africa.”
Congratulations to primary presenter Dr. Tijani Idris Ahmad Oseni (Ambrose Alli University, Ekpoma, Nigeria)
The Besrour Centre Family Medicine Early Career Researcher Awards at WONCA Asia-Pacific
Every year the Besrour Centre Family Medicine Early Career Researcher Awards are presented to early career family medicine and primary health care researchers from low- and middle-income countries who have potential to become leaders in their field. The award is generously funded by the Fondation Docteur Sadok Besrour.
- The prize recognizes the talent, effort, and contribution to research and scholarship in family medicine and primary health care in their contexts
- Early career researchers exhibit clarity of thought, scientific rigor, and originality
This year’s award was presented at the regional Asia-Pacific conference of the World Organization of Family Doctors (WONCA) in Bali, Indonesia. The 2022 Award recipients:
Best presentation: “Utilisation of and perceived access barriers to e-Health among patients with chronic conditions in primary care settings: a mixed-method study.”
Congratulations to primary presenter Dr. I. Nyoman Sutarsa (Udayana University, Indonesia)
Second-place presentation: “Feasibility outcomes of MyManis mobile application for the prevention of T2D in women with GDM: a randomized controlled trial.”
Congratulations to primary presenter Dr. Boon How Chew (University Putera, Malaysia)
Medical Education
Excellence in family medicine education and training is at the core of the Besrour Centre’s mission, and we recognize these last few years have been particularly challenging for educators and learners alike. The Besrour Centre advances medical education and training by:
Supporting the development of family medicine academic programs
Improving the training of family physicians
Strengthening the teaching capacity of family medicine programs
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Family Medicine Education and Training in Indonesia
The pandemic has reinforced the value of reciprocal learning as global family medicine colleagues innovated with limited resources to better serve vulnerable communities. Representatives from the Besrour Centre had the opportunity to visit colleagues in Indonesia in 2022 to share knowledge and foster global collaboration.
WONCA Asia Pacific Regional Conference
At WONCA 2022, the Besrour Centre’s Dr. Lynda Redwood-Campbell, Dr. Clayton Dyck, and Dr. David Ponka led a workshop titled Collaborating Globally to Build Family Physicians’ Competencies in the Post-COVID World.
– Bali Indonesia
Learning objectives:- Identify how family physicians and educators can collaborate at a global level to address the new post-COVID-19 paradigm competencies
- Explore how global family medicine COVID-19 research and educational initiatives may be applied in participants’ own contexts
Train the Trainer
The Besrour Centre’s Dr. Lynda Redwood-Campbell, Dr. Clayton Dyck, and Dr. David Ponka conducted seven Train the Trainers workshops geared to educators in the newly established family medicine residency program at Syiah Kuala University.
Syiah Kuala University – Banda Aceh, Indonesia
Learning objectives:- Apply common teaching techniques used in the clinical training of family medicine learners
- Assist learners in becoming evidence-focused family physicians
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FM Pivot
The goal of the FM Pivot educational module series is to improve the resilience of global and local health systems through capacity building of family physicians in responding and adapting to future global health emergencies.
In 2022, following the launch of the first FM Pivot module, Besrour Centre launched two new modules that build on the experience and knowledge gained by the global family medicine community through the pandemic:To learn more, please visit www.fmivot.ca.
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Fellowships
The Besrour Centre’s Medical Education Research Fellowship provides early-career family physicians with the opportunity to strengthen teaching, training, and research skills, which in turn improve family medicine education and build research capacity in their context.
Through the generosity of Scotiabank and MD Financial, and administration by the FAFM, the Besrour Centre received 13 applications and awarded this opportunity to two recipients to advance primary care around the world:
Dr. Patricia Eseigbe from Nigeria is a Senior Lecturer, Consultant Family Physician, and a Public Health Specialist working at both Bingham University and Bingham University Teaching Hospital, Jos Nigeria. Dr. Eseigbe’s already impressive skills in academic family medicine, will lend capacity to not only her home country of Nigeria but all West African countries.
Dr. Lala Soavina Ramarozatovo from Madagascar is an Internal Medicine Specialist, Vice Dean in charge of Research, Reform and Accreditation, Faculty of Medicine of Antananarivo. She has keen interest in population health and launching the discipline of Family Medicine in her context.
Funds are part of a five-year partnership between the CFPC and Scotiabank and MD Financial to advance primary care around the world.
Looking Ahead
As we look to the years ahead, we are proud and excited about the potential impact of several programs.
The Besrour Centre’s new Fellows will be building on our collective understanding of team-based primary care in Nigeria and launching the discipline of family medicine in Madagascar. FM Pivot will continue to propose modules of interest to our partners around the world, while FM Vax will continue to add to evidence of the importance of primary care and public health integration.
Building on the significant impact of the Global Co-RIG Phase I projects in Indonesia and South Africa, Co-RIG Phase II gets under way in 2023. With a grant of $50,000 to the successful recipient in a low- or middle-income country, the focus of Co-RIG Phase II projects is on timely innovations to address gaps in mental health support.
