Family medicine training in Sub-Saharan Africa : South-South cooperation in the Primafamed project as strategy for development

BACKGROUND. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. OBJECTIVE. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. METHODS. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. RESULTS. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. CONCLUSIONS. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels

Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa : reflections of the PRIMAFAMED network

Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference

Five Years Of Family Medicine Undergraduate Education In Ghana: A Wake-Up Call!

Objectives: Given the introduction in 2008 of undergraduate family medicine in the University of Ghana, the study aimed to identify the perceptions of medical students in Ghana about family medicine with regard to knowledge and relevance as well as specialty preferences.Design: A cross-sectional surveyMethod: Investigators conducted yearly surveys of first clinical year students at the University of Ghana School of Medicine and Dentistry over a 5-year period (2008-2012) using a semi-structured questionnaire. Data was analysed using the first class group as baseline for comparison.Main outcome measures: Trends in respondents’ awareness of different aspects of family medicine, their attitudes towards the specialty and their expressed preference or lack of preference for family medicine as a potential specialty for themselves.Results: Over the five-year period, 748 of 893 eligible first year students participated which comprised 84% of students. Awareness of family medicine as a medical specialty remained high but insignificantly declined over the period of study (88% to 80%, p=0.058). Preference for family medicine as career choice remained low at 4%, but an increase from 2% baseline though insignificant (p=0.397). The primary reason for not listing family medicine as career choice was unfamiliarity with the specialty (80%).Conclusion: Although awareness of family medicine among medical students in Ghana remains relatively high, their knowledge is insufficient to influence their career decisions for family medicine. This is a wake-up call!Funding: None declaredKeywords: education, family medicine, Ghana, primary care, undergraduat

Establishing the First Geriatric Medicine Fellowship Program in Ghana

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151282/1/jgs16014.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151282/2/jgs16014_am.pd

Family physician perceptions of climate change, migration, health, and healthcare in Sub-Saharan Africa : an exploratory study

Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the populationâs interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPsâ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participantsâ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels

Sexually-Transmitted Diseases and Pelvic Infections

A sexually transmitted disease (STD), also known as sexually transmitted infection (STI) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal intercourse, oral sex, and anal sex. While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the term sexually transmitted infection (STI) has been preferred, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via use of an IV drug needle after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years.http://deepblue.lib.umich.edu/bitstream/2027.42/133165/1/medical_african_health_oer_network-sexually_transmitted_diseases_and_pelvic_infections-November10.zi

Country profile on family medicine and primary health care in Ghana

No abstract available

Community-orientated primary care : a scoping review of different models, and their effectiveness and feasibility in sub-Saharan Africa

CITATION: Mash, B., et al. 2019. Community-orientated primary care : a scoping review of different models, and their effectiveness and feasibility in sub-Saharan Africa. BMJ Global Health, 4(8):e001489, doi:0.1136/bmjgh-2019-001489.The original publication is available at https://gh.bmj.comIntroduction: Community-orientated primary care (COPC) is an approach to primary healthcare (PHC) that originated in South Africa and contributed to the formulation of the Declaration of Alma-Ata 40 years ago. Despite this, PHC remains poorly developed in sub-Saharan African countries. There has been a resurgence of interest in strengthening PHC systems in the last few years and identifying key knowledge gaps. COPC has been an effective strategy elsewhere, most notably Brazil. This scoping review investigated COPC in the sub-Saharan African context and looked for evidence of different models, effectiveness and feasibility. Methods: Databases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Studies were grouped into five categories: historical analysis, models, implementation, educational studies and effectiveness. Results: A total of 1997 publications were identified and 39 included in the review. Most publications were from the last 5 years (n = 32), research (n = 27), from South Africa (n = 27), focused on implementation (n = 25) and involving case studies (n = 9), programme evaluation (n = 6) or qualitative methods (n = 10). Nine principles of COPC were identified from different models. Factors related to the implementation of COPC were identified in terms of governance, finances, community health workers, primary care facilities, community participation, health information and training. There was very little evidence of effectiveness of COPC. Conclusions: There is a need for further research to describe models of COPC in Africa, investigate the appropriate skills mix to integrate public health and primary care in these models, evaluate the effectiveness of COPC and whether it is included in training of healthcare workers and government policy.https://gh.bmj.com/content/4/Suppl_8/e001489Publisher's versio