The role of family doctors in developing primary care systems in Asia: a systematic review of qualitative research conducted in middle-income countries 2010–2020: a systematic review of qualitative research conducted in middle-income countries 2010–2020

Background The Asia Pacific Region’s middle-income countries (MICs) face unique challenges in the ongoing
development of primary care (PC) systems. This development is complicated by systemic factors, including rapid
policy changes and the introduction of private healthcare services, as well as the mounting challenges associated
with ageing populations and increasing rates of chronic diseases. Despite the widespread acknowledgement of the
importance of family doctors in the development of PC services, relatively little is known about how these roles have
developed in Asian MICs. To address this gap, this systematic review presents a synthesis of recent research focused
on the role of family doctors within the PC systems of MICs in the Asia Pacific Region.
Methods We searched six electronic databases (CINAHL Complete, Embase, PsycINFO, PubMed, Web of Science, and
Index Medicus for the South-East Asia Region and Western Pacific) for peer-reviewed qualitative literature published
between January 2010 and December 2020. The quality of the studies was evaluated using the Critical Appraisal
Skills Programme tool. Eighteen articles were included in the analysis. Findings from these articles were extracted and
synthesised using qualitative thematic synthesis. We used the Rainbow Framework to analyse the interconnections
within health systems at the macro, meso and micro levels.
Results Our analysis of the included articles showed that family doctors play a crucial role in bridging the gap
between hospitals and communities. They are essential in adopting holistic approaches to health and wellbeing and
are in a unique position to try and address social, psychological, and biological aspects of health. Our findings also
highlight the influence of policy changes at the macro level on the role and responsibilities of family doctors at the
meso (organisational) and micro (interpersonal) levels.
Conclusions Limited research has explored the role of family doctors in the ongoing development of primary care
systems in MICs in the Asia Pacific Region. The findings of this review have significant implications for policymakers
and healthcare administrators involved in ongoing improvements to and strengthening of PC systems