South Asia
Progress on family medicine development as a specialty varies across the countries in South Asia. There are few well-established postgraduate family medicine programs in the region, and less number of graduates each year. An interesting trend is the huge variability in types of postgraduate family medicine training offered ranging from short-term training to residencies. This could be due to the need to boost and promote family medicine training in the country in order to increase the family physicians in the workforce. There is a widespread lack of recognition for family medicine as a specialty among the general population and undergraduate medical students despite the advances in training in some countries like India and Nepal. This lack of recognition is partly due to the existing myths about the practice such as; the doctors treat cough and cold.
Majority of the countries have an established family medicine societies. In most countries people prefer to see the specialist rather than a family physician. This trend could be due to the cultural values, historical perspectives, lack of education, and satisfaction with care received in these countries. Further, the varied level of training available, but not mandatory could create differences in the way family medicine is practiced within a country, this could either satisfy or not satisfy a patient.
There are some significant barriers commonly seen in few countries such as an urban rural divide in India, Nepal, and Pakistan, which leads to inequities in terms of accessing the healthcare system. Geography is another major barrier in Maldives, Nepal, and others, since people living in remote areas cannot easily access healthcare services. Rural areas and people with low income usually receive care from inexperienced professionals and not family physicians due to the shortage of workforce.
A very interesting trend emerges in countries in close proximity to countries with established family medicine training and systems such as India, Nepal, and Pakistan compared to countries that are more isolated from other countries such as Maldives. Countries in close proximity to each other can serve as models for each other to follow, while countries which are far away from other countries could find it difficult to establish family medicine and equitable healthcare for the people.
A positive finding was that collaboration and partnerships between countries with established family medicine and those without family medicine could lead to improvements in the healthcare system in addition to making it more efficient. This could be seen in Nepal, where Canada had partnered with a University to start a training program that has now become one of the most well respected programs and bridges a gap in the delivery of primary care services.