PubMed · 13154589
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W R LAIRD. 1954-04-01. Louis Marshall.. https://doi.org/10.1056/nejm195404012501306
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BACKGROUND: Developing countries are facing the challenge of developing a family practice culture in a context in which clinical practice remains strongly associated with hospital practice. To what extent can professional exchange between GPs from North and South fuel novel professional identities in family practice? OBJECTIVES: Assess to what extent a North-South professional exchange programme involving rural GPs from Mali and France affected practice development and professional identity formation of Malian GPs. METHODS: Qualitative analysis of 19 exchanges between rural GPs from Mali and France based on (i) interviews; (ii) retrospective report analysis; (iii) field observation of three exchanges; (iv) workshop with Malian GPs; and (v) workshop with French GPs. RESULTS: Malian GPs reported increased self-esteem, increased concern for doctor-patient communication and innovations in practice organization. Although Malian participants considered a transfer from France's general practice irrelevant, the experience was thought provoking. The interpersonal and professional interaction was crucial. The Malian Rural Doctors Association provided a platform to capitalize on individual experiences in a process of collective professional identity construction. Costs of the programme were kept low, limiting possible side expectations of participants. CONCLUSIONS: North-South professional exchange can contribute to professional development. Exchange programmes should be designed as mutual learning processes, rather than unilateral assistance or transfer of practice models. Southern family practitioners are likely to improve primary care to individuals and families, while Northern GPs can draw lessons from the community perspective of primary health care in the South. Recruitment and preparation of participants are crucial, as well as collective reflection upon return.
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As human papillomavirus (HPV) vaccines come to market, they will face education and training challenges similar to those of other new vaccines, along with HPV-specific issues. Recent studies document stark knowledge gaps about HPV at all levels--among policy makers, healthcare providers, parents, and teens--in both the industrialized and developing worlds. Pharmaceutical companies, public health advocates, medical trainers, and health educators need to understand their diverse audiences and respond appropriately to the needs of each. They also must use research-based communication strategies and materials to most effectively, and accurately, convey the need for an HPV vaccine and to manage expectations about how the vaccine can, and cannot, protect women and men.