The state of family medicine training programmes within the Primary Care and Family Medicine Education network

Abstract

The 2019 Primary Care and Family Medicine Education network (Primafamed) meeting in Kampala, Uganda, included a workshop that aimed to assess the state of postgraduate family medicine training programmes in the Primafamed network. Forty-six people from 14 African and five other countries were present. The evaluation of programmes or countries according to the stages of change model was compared to a previous assessment made 5 years ago. Most countries have remained at the same stage of change. Two countries appeared to have reversed their readiness to change as Rwanda moved from relapse to pre-contemplation and Mozambique moved from action to contemplation. Malawi, Zambia and Zimbabwe increased their readiness to change and moved from contemplation to action. Countries in the region remain quite diverse in terms of their commitment to family medicine training. Within Primafamed, it is possible for countries with a more advanced stage of change to assist countries with an earlier stage. Primafamed is also supported by a variety of partners outside of Africa. Five years after the previous country-level assessment, family medicine in Africa continues to span across all levels of the stages of change model. Stage-matched interventions aligned with the needs of individual countries should follow. Consequently, this workshop report will serve as a mandate and compass for Primafamed’s actions over the next few years, aimed at designing and delivering these interventions. As reiterated in the 2019 Kampala commitment, we should continue developing the discipline of family medicine (the medical ‘specialty’ of primary care), through alignment of our training programmes to the health needs in the African region.

Communication skills of general practitioners in Nairobi, Kenya: a descriptive observational study

“…Including more communication skills training in the undergraduate curriculum may be necessary and postgraduate training in family medicine could also be a valuable avenue for doctors to learn PCC. 37 , 38 …”

“…Including more communication skills training in the undergraduate curriculum may be necessary and postgraduate training in family medicine could also be a valuable avenue for doctors to learn PCC. 37,38 Focusing on the service delivery design in this setting could also address the limited scope and comprehensiveness of primary care. 6,26 Increased involvement of the family medicine department in the primary care setting and deploying the newly graduated family physicians to these clinics could improve communication and service delivery.…”

Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature

“…Support from key stakeholders Support from government was identified as a crucial factor in the successful launch of FM within a country. 27,28,44,55,56 Clear government policies advocating for the adoption of FM within healthcare systems, including strategies for the training and deployment of FPs, were a significant enabler for the roll out of FM. 48 Conversely, opposition or ambivalence by governments posed a significant barrier to the successful adoption of FM.…”

The contribution of family physicians to African health systems

“…The supply of family physicians in African countries is typically limited, and many countries have only recently initiated training programmes. 2 The impact of family physicians is therefore low, and deployment has not yet gone to scale. Policy and decision-makers may be confused about the roles of family physicians in the African context and unsure as to whether the return on investment is worthwhile.…”