The views of key leaders in South Africa on implementation of family medicine : critical role in the district health system

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dc.contributor.authorMoosa, Shabiren_ZA
dc.contributor.authorMash, Boben_ZA
dc.contributor.authorDerese, Anselmeen_ZA
dc.contributor.authorPeersman, Wimen_ZA
dc.date.accessioned2014-07-28T09:24:43Z
dc.date.available2014-07-28T09:24:43Z
dc.date.issued2014-06
dc.date.updated2014-07-01T07:04:17Z
dc.descriptionCITATION: Moosa, S., Mash, B., Derese, A. & Peersman, W. 2014. The views of key leaders in South Africa on implementation of family medicine: critical role in the district health system. BMC Family Practice, 15(1):125, doi:10.1186/1471-2296-15-125.en_ZA
dc.descriptionThe original publication is available at http://www.biomedcentral.com/1471-2296/15/125en_ZA
dc.description.abstractBackground: Integrated team-based primary care is an international imperative. This is required more so in Africa, where fragmented verticalised care dominates. South Africa is trying to address this with health reforms, including Primary Health Care Re-engineering. Family physicians are already contributing to primary care despite family medicine being only fully registered as a full specialty in South Africa in 2008. However the views of leaders on family medicine and the role of family physicians is not clear, especially with recent health reforms. The aim of this study was to understand the views of key government and academic leaders in South Africa on family medicine, roles of family physicians and human resource issues. Methods This was a qualitative study with academic and government leaders across South Africa. In-depth interviews were conducted with sixteen purposively selected leaders using an interview guide. Thematic content analysis was based on the framework method. Results Whilst family physicians were seen as critical to the district health system there was ambivalence on their leadership role and ‘specialist’ status. National health reforms were creating both threats and opportunities for family medicine. Three key roles for family physicians emerged: supporting referrals; clinical governance/quality improvement; and providing support to community-oriented care. Respondents’ urged family physicians to consolidate the development and training of family physicians, and shape human resource policy to include family physicians. Conclusions Family physicians were seen as critical to the district health system in South Africa despite difficulties around their precise role. Whilst their role was dominated by filling gaps at district hospitals to reduce referrals it extended to clinical governance and developing community-oriented primary care - a tall order, requiring strong teamwork. Innovative team-based service delivery is possible despite human resource challenges, but requires family physicians to proactively develop team-based models of care, reform education and advocate for clearer policy, based on the views of these respondents.en_ZA
dc.description.versionPublishers' Versionen_ZA
dc.format.extent7 pages
dc.identifier.citationMoosa, S., Mash, B., Derese, A. & Peersman, W. 2014. The views of key leaders in South Africa on implementation of family medicine: critical role in the district health system. BMC Family Practice, 15(1):125, doi:10.1186/1471-2296-15-125.en_ZA
dc.identifier.issn1471-2296 (online)
dc.identifier.otherdoi:10.1186/1471-2296-15-125
dc.identifier.urihttp://hdl.handle.net/10019.1/95514
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights.holderShabir Moosa et al.; licensee BioMed Central Ltd.en_ZA
dc.subjectFamily medicine -- South Africaen_ZA
dc.subjectPhysicians (General practice -- South Africaen_ZA
dc.subjectCommunity health services -- South Africaen_ZA
dc.subjectPrimary health care -- South Africaen_ZA
dc.titleThe views of key leaders in South Africa on implementation of family medicine : critical role in the district health systemen_ZA
dc.typeArticleen_ZA
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