Scaling up family medicine and primary health care in Africa.

Author(s) Jan De Maeseneer1, Maaike Flinkenflögel2
Affiliation(s) 1Department Family Medicine and Primary Health Care, Ghent University, Gent, Belgium, 2Department of Family Medicine and Primary Health Care, Ghent University, Gent, Belgium.
Country - ies of focus Global
Relevant to the conference tracks Health Workforce
Summary Increasingly, there is an emphasis upon the need for scaling up the capacity of primary health care. The Primafamed-network (www.primafamed.ugent.be), at its workshop in November 2012 formulated a statement on human resources for primary health care. They formulated a plan that will lead to 30.000 new family physicians in sub-saharan Africa by 2020. There is an increasing need for skilled primary health care providers, and also family physicians at the primary health care level in Africa. Until now, in different African countries only a small number of family physicians have been trained. There is a huge problem of recruitment of family physicians in the medical faculties.
Background Accessible and comprehensive primary health care is a key factor to solve the health problems of the developing countries, also in Africa. There is a need to scale up both quality and capacity of family medicine in the context of primary health care teams in Africa. The actual programs have only been able to train a very limited number of family physicians. Increasingly, countries and ministries of health recognised the importance of this discipline to strengthen health systems.
Objectives To formulate a policy statement to scale up family medicine and primary health care in Africa and to develop a strategy accordingly.
Methodology At the recent Primafamed-workshop in Vic Falls (Zimbabwe), a gathering of African representatives from 20 African countries discussed the different strategic options in order to scale up the capacity of family medicine and primary health care. The result was a statement published in the African Journal of Primary Health Care and Family Medicine (http://www.phcfm.org).
Results Starting from reports from various countries, with a diverse scale of strategic approaches to capacity building in family medicine, a debate formulated a statement on scaling up. Important choices are related to the duration of the training, increasing the recruitment from undergraduate curriculum, and utilising appropriate educational strategies to train family physicians in the communities. Increasing exposure in undergraduate training to family and community service is essential to improve recruitment. Although some countries are in favour of a 4-years training, probably a 2-years program will be able to contribute to the achievement of the needed scaling up to capacity.
Conclusion The participants agreed that, if the strategy could lead to the fact that 50% of the graduates would be trained in family medicine from 2013 onwards, this will lead to 30.000 new family physicians in sub-saharan Africa by 2020 in a 2-year program.

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