Shirley Esneda Mendoza-Rincón, Ma Gpe Alvarado-Rodríguez, Fátima Liz González-Ayala, Lusy Paulyna Orellana-Navarrete, Rita Inés Trujillo-Sagel, Kelly De la Cruz-Torralva, Eduardo Luis Caycedo-Guevara, Maria Sofia Cuba-Fuentes, Mauricio Alberto Rodríguez-Escobar
The increase in family medicine specialists in the region calls for integrated policies on training, funding, and organization to translate these advances into sustainable improvements in quality, problem-solving capacity, and equity; evaluative studies are needed to guide implementation. Employability, and service organization to translate these advances into sustainable improvements in quality, problem-solving capacity, and equity. Beyond workforce expansion, strengthening the professional identity of family physicians and their integration within communities may contribute to the long-term sustainability of health systems and Primary Health Care. Further evaluative studies are needed to guide policy implementation and assess impact.
BACKGROUND: Family Medicine is fundamental to effective Primary Health Care (PHC), yet its development across Latin America has been uneven, constraining access, resolution and equity.
OBJECTIVE: To synthesize workforce trends and policy drivers shaping the expansion of Family Medicine in seven Latin American countries (2014-2024) and to propose actionable policy and implementation priorities for PHC strengthening.
METHODS: Directed multinational mixed-methods review (Argentina, Colombia, Ecuador, Mexico, Paraguay, Panama, Peru). We integrated a structured search of peer-reviewed and gray literature, official documents and national workforce registries with secondary data analysis (standardized rates per 100,000 inhabitants) and country-level validation by national experts from the Ibero-American Network of Family Medicine (IBIMEFA).
RESULTS: All countries showed increases in Family Medicine specialists, with heterogeneous magnitude and pace, rapid expansion in Ecuador and Paraguay; steady growth in Colombia and Peru; incremental increases in Mexico and Argentina; and nascent development in Panama and slower workforce growth in Panama despite a well-established specialty training system. Enablers included expansion of residency capacity, explicit PHC policy prioritization, and university service partnerships. Key barriers were fragmented financing and organization, inequitable geographic distribution of specialists, and weak formalization of Family Medicine as the system's entry point.
CONCLUSION: The increase in family medicine specialists in the region calls for integrated policies on training, funding, and organization to translate these advances into sustainable improvements in quality, problem-solving capacity, and equity; evaluative studies are needed to guide implementation. Employability, and service organization to translate these advances into sustainable improvements in quality, problem-solving capacity, and equity. Beyond workforce expansion, strengthening the professional identity of family physicians and their integration within communities may contribute to the long-term sustainability of health systems and Primary Health Care. Further evaluative studies are needed to guide policy implementation and assess impact.