Between August and October 2025, a mosquito-borne chikungunya virus (CHIKV) outbreak occurred in XXX (XXX XXX), with 18 confirmed cases. In response, local general practitioners (GPs) were mobilized to support the identification of suspected cases and raise awareness among patients regarding symptoms and indications for medical care. In parallel, a participatory science initiative was conducted in collaboration with Unité des Virus Emergents (UVE, XXX), supported by local authorities.The project aimed to assess the extent of viral circulation in the city by engaging volunteers, recruited throught their GP, and equipped with household mosquito traps.A prospective epidemiological study was conducted in which participants brought collected mosquitoes to their GP’s practice. Samples were then tested at UVE for CHIKV detection. All participants received individualized feedback regarding CHIKV detection in mosquitoes collected from their homes, along with targeted recommendations for mosquito-bite prevention and infection risk reduction.GPs were sensitized to existing clinical recognition tools and weekly updates from health authorities on ongoing CHIKV circulation. During routine consultations, patients were sensitized to ensure early identification of suspected cases, with particular attention given to individuals at higher risk of severe disease. Through GP surveillance, 10 symptomatic patients were identified and confirmed positive for CHIKV by laboratory testing. The participatory science project generated mosquito collections from 33 households and additional public areas, yielding more than 2,500 mosquitoes. CHIKV was detected in one area where human cases had previously been reported. The concerned participant was promptly informed, and vector-control interventions were reinforced due to concurrent virus detection in both mosquitoes and humans.This initiative illustrates how primary care can significantly enhance the response to outbreaks in areas with established mosquitoes. GPs contributed to early case detection, dissemination of accurate health information, and promotion of preventive behaviors. Their close connection to the community facilitated rapid engagement in the participatory science project, generating actionable entomological evidence data supporting timely vector-control measures.This experience highlights the pivotal role of GPs in detecting and mitigating a CHIKV outbreak in France. Sustained collaboration between clinicians, public health agencies, and research institutions should be promoted to enhance preparedness for future arboviral threats.

The full-scale war in Ukraine has produced a steep rise in population mental-health needs and massive internal and external displacement, straining specialist services and placing primary care at the frontline of psychosocial support. Recent national and international assessments report high burdens of depression, anxiety and PTSD among civilians and internally displaced persons (IDPs).To synthesize evidence from Scopus and Web of Science indexed literature and national reports, to reflect on practice-based experiences from Ukrainian primary care, and to propose pragmatic, scalable interventions family physicians can implement to identify, manage, and refer patients with war-related mental health problems.I conducted a focused narrative review of peer-reviewed studies (2019–2025) indexed in Scopus and Web of Science, supplemented with WHO country data and national Ministry of Health reports, and combined these findings with practice-based reflections and a short illustrative case from a primary-care clinic in Ukraine. The 2019 WHO STEPS survey is used as baseline population health data but is contrasted with post-2022 evidence due to massive population displacement and changed risk profiles.Data taken from population health surveys (WHO STEPS 2019) document important baseline NCD and mental-health risk factors but do not reflect wartime displacement and trauma exposure. Contemporary studies and health-needs assessments indicate that ~1 in 3 adults report symptoms consistent with a mental-health disorder since the 2022 escalation, with even higher rates among IDPs (depression/PTSD estimates frequently >30–50%). Service-level reports highlight expanded primary-care mental-health packages and mhGAP-based training, but coverage and workforce shortages remain critical.I recommend (1) systematized screening in primary care using brief validated tools; (2) stepped care with low-intensity psychosocial interventions delivered by trained family physicians/nurses; (3) clear referral pathways to specialist MHPSS (mental health and psychosocial support); (4) integration of telemedicine for displaced populations; and (5) workforce support and rapid training roll-out (mhGAP, brief CBT skills).Family physicians play a key role in conducting screening, identifying mental health disorders, and providing appropriate interventions during wartime. Rapid adaptation of clinical workflows, targeted workforce training, and strengthening of referral pathways are realistic priorities for reducing the mental-health care gap in conflict settings.

Life-threatening emergencies in primary care are infrequent but require rapid, coordinated action across professional and organisational boundaries. Traditional training approaches primarily focus on individual competencies and may overlook system-level weaknesses. In-situ simulation offers a method for testing real-world emergency readiness within everyday clinical environments.This study aimed to assess emergency response readiness, team coordination, and latent safety threats in primary care using interdisciplinary in-situ simulation.Interdisciplinary in-situ simulations were conducted across all units of a large urban community health centre in 2025. Scenarios included adult and infant cardiac arrest, as well as outpatient triage, performed in real-world clinical settings such as dental clinics, laboratories, and general outpatient areas. Primary outcomes were the emergency response team's arrival time and adherence to critical resuscitation steps; secondary outcomes focused on identifying organisational and environmental safety threats.Emergency response teams consistently arrived within the predefined target of 120 seconds. The mean response time was 50.8 ± 24.2 seconds, demonstrating rapid activation across diverse primary care settings. In-situ simulation revealed recurrent latent safety threats, including spatial limitations, delayed access to emergency equipment, and variable familiarity with emergency protocols, particularly in non-traditional clinical environments.The findings suggest that in-situ simulation serves not only as an educational tool but as a practical system test for primary care organisations. While response times met established benchmarks, simulations exposed context-specific vulnerabilities that are unlikely to be identified through off-site or classroom-based training. Interdisciplinary participation proved essential, as emergencies frequently occurred in settings where staff are not routinely exposed to acute care scenarios. By revealing organisational, spatial, and procedural gaps, in-situ simulation enables targeted quality and safety interventions tailored to local practice realities.In-situ simulation offers a feasible and practical approach to assessing emergency preparedness and enhancing quality and safety in primary care. Embedding this method into routine quality improvement processes may strengthen system resilience beyond the acquisition of individual skills.

During the first COVID-19 wave, health systems faced uncertainty and the need for rapid medical staffing reinforcement. In several settings, junior doctors’ representatives initiated mobilisation initiatives. Understanding how residents can take leadership and build an operational reinforcement system may inform preparedness for future crises.To describe the step-by-step construction of a resident-led medical reinforcement mobilisation system during the first COVID-19 wave, and to document its operational deployment.Historical approach using contemporaneous heterogeneous sources available during decision-making (11 March–10 May 2020). The corpus included selected email threads and attachments, local/national communications, successive versions of the mobilisation procedure, protocols in use, and digital tools used for monitoring the epidemic and mobilisation. Sources were analysed to reconstruct chronological sequences of the system’s construction, model the procedure, and quantify mobilisation.Five chronological sequences were identified: (1) awareness of anticipated staffing needs, (2) collegial definition of mobilisation criteria, (3) creation of a volunteer pool using an online questionnaire, (4) definition of mobilisation rules and authorisation workflow with institutional actors, and (5) consolidation during implementation through shared digital tracking tools. The system highlighted residents’ leadership in proposing rapid, simple solutions based on digital tools and ground-level coordination. Quantitatively, 217 volunteers responded to the mobilisation questionnaire; 130 residents were identified as immediately mobilisable, and 47 residents were effectively redeployed through the procedure.This resident-led, digitally supported process illustrates how junior doctors can contribute to crisis governance and rapid operational coordination when formal staffing pathways are constrained. It also raises questions about the distribution of decision-making and the integration of “bottom-up” initiatives within centralised crisis management.A resident-led mobilisation system, co-constructed with institutional stakeholders and supported by simple digital tools, can rapidly structure medical reinforcement during a crisis and provides a reproducible model for future emergency preparedness.

Armed conflicts disrupt health systems not only through acute injuries but also by limiting access to routine and preventive health services. Vulnerable populations, especially those with chronic conditions and mental health needs, are affected first. Despite this, war-related health literature largely focuses on emergency response and hospital-based care, while the role of family medicine and primary health care (PHC) under prolonged conflict conditions remains less explored. In many settings, family doctors continue to provide first-contact and longitudinal care within their communities. This issue is particularly relevant for countries such as Turkey due to their geographical proximity and humanitarian engagement with conflict-affected regions.This review aims to synthesise recent evidence on the functioning of family medicine and PHC services in armed conflict settings, focusing on equitable access to care, safety and freedom for health workers and patients, and solidarity mechanisms supporting service continuity.A literature search was conducted in November 2025 using PubMed, Scopus, and Google Scholar. Search terms related to family medicine (“family physician”, “family doctor”, “general practitioner”, “primary health care”) were combined with war- and conflict-related keywords. Studies published within the last five years were included. Of 405 records identified, 16 studies addressing community-based primary care or family medicine roles in conflict settings met the inclusion criteria. Studies focusing exclusively on hospital-based care were excluded.The included studies reported widespread disruptions in preventive services and chronic disease management. Continuity of care for non-communicable diseases, particularly diabetes and hypertension, declined in most settings. In contrast, core PHC services such as antenatal care, childhood immunisation, and basic emergency obstetric care were relatively prioritised through family medicine-based structures. Mental health needs, including anxiety, depression, and post-traumatic stress disorder, increased substantially and were often addressed at the primary care level. Telemedicine, mobile clinics, and task shifting to community health workers were commonly used to support service delivery.Family doctors frequently assumed expanded roles beyond clinical care, including psychosocial support, coordination of limited resources, and maintaining trust within affected communities.Family medicine plays a central yet often overlooked role in sustaining essential health services and supporting health system resilience during armed conflict.

Simulation-based education is increasingly recognized as a key strategy to promote patient safety and improve the management of emergencies within Primary Care Teams (PCT). The Catalan Health Institute (ICS) implemented a large-scale programme of Simulated Clinical Stations to enhance competencies in urgent and high-risk situations across 186 primary care teams in Catalonia. This study evaluates the programme’s educational impact in terms of knowledge acquisition and professional satisfaction.A prospective pre–post observational study including 8,916 professionals (physicians, nurses, administrative staff) was conducted at the CAP Balmes simulation centre. Participants completed nine standardized simulated stations using trained actors and structured checklists. Knowledge was assessed through pre/post tests (0–10 scale), and satisfaction through a 76-item Likert scale questionnaire (0–6). Data were collected anonymously. Statistical analyses involved independent t-tests and effect size estimation.Globally, mean knowledge scores increased from 5.1/10 to 7.6/10 (+49%, p < 0.001; effect size d = 1.2). Improvements were consistent across all scenarios: • Sepsis Code: +83% • Suicide Code: +74% • AMI/Stroke: +36% • BLS/CPR: +29% Administrative staff, despite lower baseline scores, achieved the greatest relative gains. Overall satisfaction was very high (5–6/6 across all dimensions), confirming strong acceptance of the methodology.This large-scale intervention demonstrates that structured simulation with standardized scenarios and trained actors is feasible, impactful, and transferable across diverse primary care settings. Beyond clinical competence, the programme strengthens teamwork, communication, and ethical decision-making in complex cases, including chronic care situations with shared decision preferences (e.g., PIIC No-RCP scenarios).Simulated Clinical Stations are a scalable and high-value educational strategy that significantly improve emergency preparedness and patient-safety competencies in primary care. Their multidisciplinary, immersive and reproducible format offers a robust model for other healthcare systems seeking to enhance workforce readiness and quality of care.

Thailand’s deep southern provinces have experienced recurring shocks from public health emergencies, natural disasters, and prolonged sociopolitical instability. Strengthening local health system resilience is essential to maintain essential services and protect vulnerable populations. This study explored how local health actors—across public, private, and community sectors—demonstrated absorptive, adaptive, and transformative capacities within a decentralized health governance framework.The primary objective was to examine the processes and enablers of local health system resilience in southern Thailand. The secondary objectives were (1) to assess governance and leadership mechanisms facilitating cross-sector coordination, and (2) to identify community and innovation strategies that strengthened primary care resilience during crises.A qualitative case study was conducted in a district hospital in the deep south of Thailand. Thirty-seven participants were purposively selected, including health professionals, public health officers, family physicians, nurses, non-communicable disease (NCD) patients, village health volunteers (VHVs), community and religious leaders, local government representatives, and private partners. Inclusion criteria included the ability to communicate in Thai and willingness to participate with informed consent. Exclusion criteria were inability to communicate in Thai, unwillingness to participate, or non-residency based on census records. Data were collected through in-depth interviews and document review, and analyzed thematically using a resilience framework emphasizing absorptive, adaptive, and transformative capacities.Eight themes emerged: (1) preparedness and planning through early emergency operations and local resource mobilization; (2) strong governance linking hospitals, local governments, and communities; (3) dedicated workforce resilience despite burnout; (4) community-led logistics mitigating supply shortages; (5) digital platforms supporting communication and teleconsultation; (6) flexible service delivery ensuring care for fragile populations; (7) community participation driving shared ownership of health initiatives; and (8) psychological support fostering solidarity and compassion. These mechanisms collectively enhanced system functionality under crisis.Resilience in Thailand’s local health systems is both institutional and social—rooted in trust, collaboration, and community participation. Digital innovation and faith-based solidarity supported rapid adaptation and sustained service delivery.Synergistic governance, community engagement, and adaptive innovation underpin local health system resilience. Strengthening these elements is vital for building people-centred, resilient primary health care and advancing universal health coverage in fragile contexts.