Developing the evidentiary basis for family medicine in the global context

A total of 48 randomized controlled trials assessed the effects of community or lay health worker interventions in primary care, compared with usual care (led by doctors). Benefits included increased childhood immunizations, promotion of breastfeeding, and reduced childhood mortality and morbidity

A total of 34 studies examined substituting nurse practitioners for doctors working in primary care. Patient outcomes were similar for nurse practitioners and doctors, and patients were more satisfied with care from nurse practitioners. However, there were no associated cost savings

Only a third of the studies on community health workers and none of the studies on nurse practitioners were carried out in low- and middle-income countries, thus potentially limiting the applicability of the findings to these countries