The bird’s-eye perspective: how do district health managers experience the impact of family physicians within the South African district health system? A qualitative study

  • Klaus B Von Pressentin Stellenbosch University
  • Robert J Mash Stellenbosch University
  • L Baldwin-Ragaven University of the Witwatersrand
  • R P G Botha University of Pretoria
  • I Govender Sefako Makgatho Health Sciences University
  • W J Steinberg University of the Free State
Keywords: family physicians, healthcare system, primary health care, healthcare team, leadership

Abstract

Background: Health policy-makers in Africa are looking for local solutions to strengthen primary care teams. A South African national position paper (2015) described six aspirational roles of family physicians (FPs) working within the district health system. However, the actual contributions of FPs are unclear at present, and evidence is required as to how this cadre may be able to strengthen health systems. Methods: Using semi-structured interviews, this study sought to obtain the views of South African district health managers regarding the impact made by FPs within their districts on health system performance, clinical processes and health outcomes. Results: A number of benefits of FPs to the health system in South Africa were confirmed, including: their ability to enhance the functionality of the local health system by increasing access to a more comprehensive and coordinated health service, and by improving clinical services delivered through clinical care, capacitating the local health team and facilitating clinical governance activities. Conclusions: District managers confirmed the importance of all six roles of the FP and expressed both direct and indirect ways in which FPs contribute to strengthening health systems’ performance and clinical outcomes. FPs were seen as important clinical leaders within the district healthcare team. Managers recognised the need to support newly appointed FPs to clarify their roles within the healthcare team and to mature across all their roles. This study supports the employment of FPs at scale within the South African district health system according to the national position paper on family medicine. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2018; DOI: 10.1080/20786190.2017.1348047

Author Biographies

Klaus B Von Pressentin, Stellenbosch University
Division of Family Medicine and Primary Care Stellenbosch University
Robert J Mash, Stellenbosch University
Division of Family Medicine and Primary Care Stellenbosch University
L Baldwin-Ragaven, University of the Witwatersrand
Department of Family Medicine School of Clinical Medicine University of the Witwatersrand
R P G Botha, University of Pretoria
Department of Family Medicine University of Pretoria
I Govender, Sefako Makgatho Health Sciences University
Department of Family Medicine Sefako Makgatho Health Sciences University
W J Steinberg, University of the Free State
Department of Family Medicine University of the Free State
Section
Research Articles