BACKGROUND: The World Health Organization encourages comprehensive primary care within an ongoing personalised relationship, including family physicians in the primary healthcare team, but family medicine is new in Africa, with doctors mostly being hospital based. African family physicians are trying to define family medicine in Africa, however, there is little clarity on the views of African country leadership and their understanding of family medicine and its place in Africa. AIM: To understand leaders' views on family medicine in Africa. DESIGN AND SETTING: Qualitative study with in-depth interviews in nine sub-Saharan African countries. METHOD: Key academic and government leaders were purposively selected. In-depth interviews were conducted using an interview guide, and thematically analysed. RESULTS: Twenty-seven interviews were conducted with government and academic leaders. Responders saw considerable benefits but also had concerns regarding family medicine in Africa. The benefits mentioned were: having a clinically skilled all-rounder at the district hospital; mentoring team-based care in the community; a strong role in leadership and even management in the district healthcare system; and developing a holistic practice of medicine. The concerns were that family medicine is: unknown or poorly understood by broader leadership; poorly recognised by officials; and struggling with policy ambivalence, requiring policy advocacy championed by family medicine itself. CONCLUSION: The strong district-level clinical and leadership expectations of family physicians are consistent with African research and consensus. However, leaders' understanding of family medicine is couched in terms of specialties and hospital care. African family physicians should be concerned by high expectations without adequate human resource and implementation policies.
BACKGROUND: The World Health Organization encourages comprehensive primary care within an ongoing personalised relationship, including family physicians in the primary healthcare team, but family medicine is new in Africa, with doctors mostly being hospital based. African family physicians are trying to define family medicine in Africa, however, there is little clarity on the views of African country leadership and their understanding of family medicine and its place in Africa. AIM: To understand leaders' views on family medicine in Africa. DESIGN AND SETTING: Qualitative study with in-depth interviews in nine sub-Saharan African countries. METHOD: Key academic and government leaders were purposively selected. In-depth interviews were conducted using an interview guide, and thematically analysed. RESULTS: Twenty-seven interviews were conducted with government and academic leaders. Responders saw considerable benefits but also had concerns regarding family medicine in Africa. The benefits mentioned were: having a clinically skilled all-rounder at the district hospital; mentoring team-based care in the community; a strong role in leadership and even management in the district healthcare system; and developing a holistic practice of medicine. The concerns were that family medicine is: unknown or poorly understood by broader leadership; poorly recognised by officials; and struggling with policy ambivalence, requiring policy advocacy championed by family medicine itself. CONCLUSION: The strong district-level clinical and leadership expectations of family physicians are consistent with African research and consensus. However, leaders' understanding of family medicine is couched in terms of specialties and hospital care. African family physicians should be concerned by high expectations without adequate human resource and implementation policies.
Authors: John W Beasley; Barbara Starfield; Chris van Weel; Walter W Rosser; Cynthia L Haq Journal: J Am Board Fam Med Date: 2007 Nov-Dec Impact factor: 2.657
Authors: James C Martin; Robert F Avant; Marjorie A Bowman; John R Bucholtz; John R Dickinson; Kenneth L Evans; Larry A Green; Douglas E Henley; Warren A Jones; Samuel C Matheny; Janice E Nevin; Sandra L Panther; James C Puffer; Richard G Roberts; Denise V Rodgers; Roger A Sherwood; Kurt C Stange; Cynthia W Weber Journal: Ann Fam Med Date: 2004 Mar-Apr Impact factor: 5.166
Authors: Klaus B von Pressentin; Robert J Mash; Laurel Baldwin-Ragaven; Roelf Petrus Gerhardus Botha; Indiran Govender; Wilhelm Johannes Steinberg; Tonya M Esterhuizen Journal: Ann Fam Med Date: 2018-01 Impact factor: 5.166
Authors: Kéfilath Bello; Jan De Lepeleire; Jeff Kabinda M; Samuel Bosongo; Jean-Paul Dossou; Evelyn Waweru; Ludwig Apers; Marcel Zannou; Bart Criel Journal: PLoS One Date: 2021-10-22 Impact factor: 3.240
Authors: Marietjie R de Villiers; Francois J Cilliers; Francois Coetzee; Nicoline Herman; Martie van Heusden; Klaus B von Pressentin Journal: BMC Med Educ Date: 2014-10-22 Impact factor: 2.463