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通过创建“实践共同体”作为一个有利平台，通过共享学习、能力建设和合作研究来应对各自国家的多发病挑战，从而促进全球南南合作，研究中低收入国家的多发病问题。我们预计，在初级保健多发病领域的领先者英国的大力支持下，印度和巴西之间的这一互惠互利的联盟不仅将促进个别国家的多发病研究，还将进一步导致更大规模的跨洲(南亚-南美-英国)合作，并为LMIC多发病网络铺平道路。该项目的主要目标是：1.在公共卫生保健环境中建立系统并发挥协同作用，利用现有的网络和机构，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，发展多发病方面的“实践共同体”。这一实践社区将成为一个自我驱动的有凝聚力的平台，并将保持该区域的研究势头，并制定与当地相关的设计，以减轻多发性疾病患者的护理挑战。2.为全科医生、公共卫生研究人员、院士和卫生服务管理人员提出一个简单但有用的能力建设框架/培训计划，以了解多发病对医疗保健和患者的多重挑战，并确定作为团队应对这一挑战的紧迫研究优先事项。3.我们认为，这反过来将改善对初级保健中多种疾病的评估和管理，通过提供基于证据的持续、协调和量身定制的护理，并以咨询方式制定、设计或促进具体情况的护理方案，从而改善患者的预后。4.通过与政策和科学界分享，为在低收入和中等收入国家环境中建设多种疾病研究能力提供一个适用的模板。5.与我们的“实践社区”合作并申请大笔赠款，以开发、实施和评估以患者为中心的综合护理系统，以初级保健实践为基础，为多发性疾病患者提供服务。创建的国际和国家网络将带头倡导，并与各自国家和整个LMIC的政策制定者、卫生规划者和卫生保健管理人员接触，考虑多种疾病，同时重新调整卫生服务的方向，以在全民健康覆盖的范围内加强初级保健。在项目结果的帮助下，WEW还将继续与国家研究机构进行对话，将多病列为新的研究优先事项，并为进一步研究提供赠款机会。我们还计划通过国家讲习班、国际期刊上的出版物、利益攸关方报告和公报、准则以及与政府和非政府利益攸关方的联系，向不同的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，进一步推进多发病的研究议程，并最终影响卫生和社会政策和实践。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，并通过我们与日本研究人员的合作得到加强，从而为社会和经济发展作出重大贡献。

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.