Knowledge, Attitudes, and Practices of Primary Healthcare Practitioners in Low- and Middle- Income Countries: A Scoping Review on Genetics

Abstract Background: The growing application of genetics in individualized treatments calls for an increased role of primary healthcare practitioners (pHCPs) in diagnosing and caring for individuals with genetic conditions. PHCPs' genetics knowledge and practices must be current to ensure adequate care. Method: A scoping review was conducted to explore peer-reviewed articles on the knowledge, attitudes, and practices of pHCPs concerning genetics, genetic testing, and genetic services. English-language articles published between January 1990 and April 2022 in low- and middle-income countries (LMICs) with an emphasis on human genetics/genomics were included. Results: Twenty-eight articles from 16 LMICs in five World Health Organization-defined regions met the inclusion criteria. Over the 32 years, the number of articles from LMICs increased steadily. The Eastern Mediterranean Region (EMR) contributed the most articles (n=8), while the Western Pacific Region (WPR) had the least (n=2). Among the countries, Brazil published the most articles (n=6), while ten countries contributed one article each. Fifteen articles had components of knowledge, 19 on attitudes towards genetics, and eight included genetic practices. The results revealed a lack of knowledge among pHCPs concerning genetic diseases, emerging technologies, referral processes to genetic specialists, and clinical guidelines for managing genetic conditions. However, pHCPs attitudes towards genetic services and new technologies were generally positive. Identified barriers to genetic services included inadequate capacity, financial limitations, and religious beliefs. Conclusions: Addressing identified knowledge gaps through education is crucial for appropriate care for patients and families affected by genetic conditions. The limited published literature in LMICs on pHCPs' genetics knowledge, attitudes, and practices highlights the need for more targeted research on educational interventions. Improving pHCPs' ability to care for individuals and families with genetic conditions will ultimately lead to better patient outcomes and support for affected families.