Strengthening the district health system through family physicians
CITATION: Mash, R. & Von Pressentin, K. B. 2018. Strengthening the district health system through family physicians. South African Health Review, 2018(1):33-39.
The original publication is available at https://www.hst.org.za
In 2007, family medicine was recognised as a new speciality in South Africa and all eight medical schools began training specialist family physicians. The introduction of this new specialty can be regarded as a generic intervention in the district health system intended to strengthen clinical processes and health system performance. Family physicians have been deployed in a variety of ways, which reflects both their breadth of training and the confusion in national and provincial policy regarding their roles in the health system. This chapter discusses the conceptualisation of the different roles of family physicians; the development of family medicine training programmes; and the deployment of family physicians as part of district management teams, within district clinical specialist teams, within sub-districts, at community health centres, and in district hospitals as both clinical managers and clinicians. The chapter highlights the findings of studies that have evaluated the initial impact of family physicians on the district health system, and proposes recommendations to enhance the effective contribution of the specialty.