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

印度、巴西和英国之间的这一国际网络旨在促进全球南南合作，通过创建“实践社区”作为一个有利的平台，通过共享学习、能力建设和合作研究，在低收入和中等收入国家研究多元发展问题。我们设想，印度和巴西之间的这种相互丰富的联盟，在英国的全面支持下，初级保健多药治疗的领导者，不仅将促进各国的多药治疗研究，而且将进一步导致更大的跨大陆（南亚-南美-英国）合作，并为多药治疗的LMIC网络铺平道路。该项目的主要目标是：1。建立系统并在公共卫生保健环境中发挥协同作用，通过包括联盟建设、宣传和多学科能力建设在内的一系列战略，利用现有网络和机构发展一个关于多学科的“实践社区”。这个实践社区将是一个自我驱动的有凝聚力的平台，并将维持该地区的研究势头，并设计与当地相关的方案，以减轻患有多发性硬化症的患者的护理挑战。2.为全科医生，公共卫生研究人员，学者和卫生服务管理人员提出一个简单而有用的能力建设框架/培训计划，以了解医疗保健和患者的多重挑战，并确定直接的研究优先事项，以应对这一挑战。3.我们认为，这反过来将改善初级保健中对多发病的更好评估和管理，从而通过提供基于证据和咨询的持续、协调和量身定制的护理来改善患者的预后。4.通过与政策和科学界分享，为中低收入国家建立多学科研究能力提供一个可适应的模板。5.与我们的“实践社区”合作，并申请大笔赠款，以开发、实施和评估一个以患者为中心的综合护理系统，该系统以多发病患者的初级护理实践为基础。创建的国际和国家网络将带头宣传，并与政策制定者接触，各国和整个LMIC的卫生规划人员和卫生保健管理人员，考虑多学科，同时调整卫生服务，在全民健康保险范围内的初级保健。在项目研究结果的帮助下，wet还将继续与国家研究机构进行对话，将多学科列为新的研究重点，并为进一步研究提供资助机会。我们还计划通过国家讲习班、在国际期刊上发表文章、利益攸关方报告和公报、指导方针以及与政府和非政府利益攸关方的联系，向不同受众传播我们的调查结果。通过这些渠道，我们将深化证据基础，推进多学科的研究议程，并最终影响健康和社会政策与实践。我们的工作将在国内和国际上具有适用性，特别是在低收入和中等收入国家，通过我们与研究人员的合作，从而为社会和经济发展做出重大贡献。

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.