Catalysing multimorbidity research in Low and Middle Income Countries through a "community of practice" approach: An India-Brazil-UK Initiative

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This international network between India Brazil and UK aims to foster global south-south collaboration to research on multimorbidity across Low and Middle Income Countries by creating "community of practice" as an enabling platform to address the challenges of multimorbidity in respective countries through shared learning, capacity building and collaborative research. We envisage that this mutually enriching coalition between India and Brazil, with the overarching support of UK, a leader in primary care multimorbidity, will not only catalyse multimorbidity research in individual countries, but further lead to a larger trans-continental (South Asia- South America-UK) collaboration and pave path for the LMIC Network on multimorbidity. Principal objectives of this project are to:1. Set up systems and bring synergy within public health care environment to develop a "community of practice" on multimorbidity using the existing networks and institutions through a mix of strategies comprising coalition building, advocacy and multidisciplinary capacity building. This community of practice will be a self-driven cohesive platform and would sustain the research momentum in the region and design locally relevant for mitigating the care challenges of patients living with multimorbidity. 2. To come up with a simple yet useful capacity building framework/ training program for general practitioners, public health researchers, academicians, and health service managers to appreciate the multiple challenges of multimorbidity on health care and patients and identify the immediate research priorities to respond to this challenge as a team. 3. We believe that this in turn would improve better assessment and management of multimorbidity in primary care leading to improved patient outcomes through provision of continuous, coordinated and tailor-made care based on evidence and consultatively develop, design or contribute to contextualized care protocols. 4. To provide an adaptable template for building multimorbidity research capacity in low and middle income country settings by sharing with both policy and scientific community. 5. To collaboratively work with our "community of practice" and apply for large grant to develop, implement and evaluate a patient focused integrated system of care based in primary care practice for people with multimorbidity.The International and national network created would spearhead advocacy and engage with policy makers, health planners and health care managers in respective countries and across LMIC for considering multimorbidity while reorienting the health services to strengthen primary care under the ambit of universal health coverage. With the help of the project findings, wet would also continue dialogues with the National research agencies to include multimorbidity as a new research priority and provide grant opportunities for further research. We additionally plan to disseminate our findings with diverse audience through national workshops, publications in international journals, stakeholder reports and bulletins, guidelines and linkages with government and non-government stakeholders. Through these channels we will deepen the evidence base, further the research agenda of multimorbidity and ultimately influence health and social policy and practice. Our work will have applicability nationally and internationally especially in the low and middle income countries strengthened by our collaboration with researchers from and thus contribute significantly to the social and economic development.