Policy Bite: Big data – can we share our own?


Prof Amanda Howe and  Dr Neil Arya write:

A recurrent theme from policymakers and government leads is a request for evidence that training more family doctors adds value to the system and is cost – effective. Barbara Starfield’s work stands us in good stead, but is now over 10 years old and needs updating, especially in countries with more recent investment in services such as Brazil. Some extremely robust large studies looking at health outcomes and access to care have failed to specify primary health care indicators as a separate factor, so the contribution made by this sector remains unclear . With our academic leads, and with colleagues at WHO, WONCA is trying to ensure that we are building the database to show our value, and thus to encourage further investment in family medicine.

We now have a new opportunity to contribute to the emerging picture. Dr Neil Arya and colleagues in Canada have created a new webpage on family medicine training and practice worldwide. They have done this as a ‘Wiki’ where we can all upload relevant data: An article about their work "Family medicine around the world: overview by region" (by Neil Arya, Christine Gibson, David Ponka, Cynthia Haq, Stephanie Hansel, Bruce Dahlman, and Katherine Rouleau) was published in the June issue of Canadian Family Physician.

The article
Arya N, Gibson C, Ponka D, Haq C, Hansel S, Dahlman B, et al. Family medicine around the world: overview by region. The Besrour Papers: a series on the state of family medicine around the world. Can Fam Physician 2017;63:436-41.

On the webpage they aim to have a general summary, and data by region and individual country. The site already holds an introductory online supplement on different regions with information on individual countries. Their aim is to collate up to date and accurate information, relevant literature, which could be linked with individual countries health systems data to allow comparisons of countries and regions. The main benefit though, is development of the community allowing community participation to edit and discuss information. Neil and his colleagues want contributors to verify information and add content, to look at the textual information already included, ensure its accuracy and to suggest other references, links, websites etc. They already have many people from different regions beginning the process of editing.

Current contributors and editors are here. Data on what is happening in family medicine will be collected under headings such as “History, College, Family Medicine Training (Duration: Years: Hours: clinical vs other;) qualifications… ”. Later we are hoping to get the kind of data I have requested from our member organisations about health system level total numbers of GPs, proportion of family doctors and so on. Neil says they are also keen to get ideas on what other information will be useful, and we will liaise on this. As WHO moves to its latest workforce survey and indicator work, we may find the data on workforce and activity improves at country level, and need to ensure that what is collected does reflect our members’ input.

This is a novel collaborative approach. It is taking time to edit and evaluate, and we are grateful to the editorial board for sharing the opportunity with WONCA. The article shows the great diversity and complexity of family medicine worldwide, but the more we share data and practise ‘talking the same language’ about the aspects of the different systems, the more confident we can be when gathering evidence and presenting our case to others. Please have a look and contribute if you can!