Globally, researchers in primary care and primary health care share the common goals of strengthening the healthcare of their patients and communities through high-quality scholarly practice.1 Primary care research is a distinct research discipline and is defined as:
[R]esearch on the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.2
Furthermore, to reflect the need to expand the knowledge foundation in growing our discipline, the term ‘academic primary care’ has been coined to describe the scholarship to draw from and inform excellence in the delivery of primary care.3 As a peer-reviewed scientific journal founded in 1980, the South African Family Practice (SAFP) journal strives to provide primary care providers and scholars (reflecting both researchers and educators) with a broad range of work in the practice, training and learning of family medicine and primary health care.
Since AOSIS became our publisher in 2020,4 we have been able to track and evaluate our journal’s performance metrics. At the time of writing, the journal’s publications had attracted over 4200 citations and 768 600 downloads (2018–2023). The CiteScore has grown from 0.4 in 2012 to 1.1 in 2022 (https://www.scopus.com/sourceid/144682). As editors, we wish to ensure that the original scientific research published in the SAFP makes a relevant contribution to strengthening our knowledge foundation of Southern African primary health care. In line with editorial practices published elsewhere,5 we performed a cross-sectional descriptive review of the original research published during 2020–2022. We agreed on key variables, including the coverage of study settings and populations, focus areas and research designs and the typology of primary care research: basic research, clinical research, health services research, health systems research and educational research.6 The authors collaborated in capturing the information in a Google form, and data were exported to Microsoft Excel and analysed in Statistical Package for Social Sciences (SPSS) using simple descriptive statistics.
During 2020–2022, 117 original research manuscripts were published. From Table 17, our journal publishes a range of studies across the typology. The clinical research category covers the Southern African quadruple disease burden,8 namely, non-communicable diseases including mental health (n = 21, 37.5%), communicable diseases including three coronavirus disease 2019 (COVID-19)-related studies (n = 10, 17.9%), maternal, newborn and child health-related studies (n = 15, 26.8%) and trauma and injury-related disorders (n = 5, 8.9%). The study settings appear to be skewed towards research conducted in urban or metropolitan areas with a rural under-representation. Most of the studies focused on adults, with only a handful of studies focusing on children and adolescents. Two-thirds of the published research was quantitative in nature, with descriptive study designs (both cross-sectional and qualitative) representing 91.5% of the published studies. A third of the studies involved cross-institutional collaboration and 40.2% of research teams represented more than one discipline. Half of the first authors were from family medicine and another third were from other medical specialities (including public health). Other primary care-related disciplines were in the minority, such as nursing, pharmacy and rehabilitation sciences. Encouragingly, student-led research represented almost a third of publications, with the majority of these being postgraduate in a 2:1 Master’s to doctoral research ratio.
TABLE 1: Findings from a simple descriptive analysis of original research published during 2020–2022 in the SAFP journal (N = 117). |
This simple descriptive analysis represents a 3-year snapshot of published research in a single South African journal. While the research published here does not represent all primary care and primary health care research performed in our context, this editorial analysis does speak to what is published in our journal and as such we are well positioned to interrogate the strengths and weaknesses of the journal’s research and future goals. The reasons our authors chose the SAFP as a suitable home for communicating their research may be quite diverse. These choices may represent an appreciation for the developmental approaches embraced by the journal’s editors and editorial board, as we are committed to also publishing smaller-scale research from under-researched settings and communities and conducted by early-career researchers, including research conducted as part of postgraduate degrees. However, we are also keen to receive more research submissions from the wider Southern African region, with improved coverage of rural settings, children and adolescents, observational analytical and experimental research and outputs from interdisciplinary teams constituting multiple sites and affiliations.
This editorial serves as a clarion call to the Southern African community of primary care researchers and clinician scholars to review their research focus and help address these persisting research gaps.9,10 A multipronged, collective approach is necessary to foster the advancement of primary health care research. The following actions are imperative:
- Increasing access to research funding aligned with primary health care policy commitments.
- Accelerating research capacity-building, through workshops and other interventions.
- Growing scholarly leaders through mentorship as well as enhancing supervisory capacity.
- Establishing interdisciplinary collaborations of research teams representing a range of practitioners, including clinician-scholars embedded in primary health care.
As the SAFP editorial team and board, we are keen to help address these actions in impactful ways. We also plan follow-up analyses of the quality, depth and breadth of research published, by incorporating additional metrics such as the primary health care measurement framework.11 Feel free to reach out to us with your ideas and suggestions on how our journal should evolve.
Acknowledgement
The editors wish to acknowledge Prof. Bob Mash as president of the South African Academy of Family Physicians (SAAFP) and editor-in-chief of the African Journal of Primary Health Care & Family Medicine (PHCFM) for his contributions, which helped inform the metrics used in the analysis. We also wish to acknowledge the SAFP editorial board for their input at the May 2023 meeting, as well as their ongoing support to grow the journal and support the SAAFP community through the interest groups in our editorial board.
References
- Olde Hartman T, Blane DN, Sturgiss E, Boeckxstaens P, Hunik L. International reflections on NAPCRG: Celebrating 50 years of learning and connecting. Fam Med Community Health. 2022;10(3):e001880. https://doi.org/10.1136/fmch-2022-001880
- Westfall JM, Wittenberg HR, Liaw W. Time to invest in primary care research – Commentary on findings from an independent congressionally mandated study. J Gen Intern Med. 2021;36(7):2117–2120. https://doi.org/10.1007/s11606-020-06560-0
- Mughal F, Atherton H, Reeve J, Mallen CD. Academic primary care: Challenges and opportunities. Br J Gen Pract. 2022;72(716):104–105. https://doi.org/10.3399/bjgp22X718577
- Von Pressentin KB. Ushering in a new year and reaching out to the next generation of family doctors. S Afr Fam Pract. 2020;62(1):e1–e2. https://doi.org/10.4102/safp.v62i1.5096
- Håkansson A. What has been published in the journal during the last three years? Scand J Prim Health Care. 2007;25(2):65. https://doi.org/10.1080/02813430701305643
- Beasley JW, Starfield B, Van Weel C, Rosser WW, Haq CL. Global health and primary care research. J Am Board Fam Med. 2007;20(6):518–526. https://doi.org/10.3122/jabfm.2007.06.070172
- Grimes DA, Schulz KF. An overview of clinical research: The lay of the land. Lancet. 2002;359(9300):57–61. https://doi.org/10.1016/S0140-6736(02)07283-5
- Mayosi BM, Lawn JE, Van Niekerk A, Bradshaw D, Karim SS, Coovadia HM. Health in South Africa: Changes and challenges since 2009. Lancet. 2012;380(9858):2029–2043. https://doi.org/10.1016/S0140-6736(12)61814-5
- Mash R, Von Pressentin K, Malan Z, et al. African primary care research: Current situation, priorities and capacity building. Afr J Prim Health Care Fam Med. 2014;6(1):1–6. https://doi.org/10.4102/phcfm.v6i1.758
- Goodyear-Smith F, Bazemore A, Coffman M, et al. Research gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: A mixed-methods approach. BMJ Global Health. 2019;4(Suppl 8):e001482. https://doi.org/10.1136/bmjgh-2019-001482
- World Health Organization. Primary health care measurement framework and indicators: Monitoring health systems through a primary health care lens [homepage on the Internet]. Web annex: Technical specifications. [cited 2023 May 24]. Available from: https://www.who.int/publications/i/item/9789240044210
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