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Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature

Lookup NU author(s): Dr Matthew Davies, Penny Ellis, Professor Richard Walker



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022 The Author(s).Objective: To identify the factors enabling and limiting family medicine (FM) programmes in Sub-Saharan Africa (SSA). Design: A narrative review was conducted by searching a variety of databases. Papers focusing on the training, de-ployment, or contribution to healthcare systems of doctors with postgraduate training in FM in SSA, published in peer-reviewed journals from 2015 onwards and in English language were included. Included papers underwent qual-itative analysis. Results: Seventy-one papers were included in the review. 38% focussed on South Africa, while papers focussing on FM in a further 15 countries in SSA were identified. Key factors enabling FM programmes are support from key stakeholders, recognition of family practitioners (FP) as specialists, international collaboration, and dedicated FPs. Key factors limiting FM programmes are a lack of sufficient and well-trained faculty, inappropriate training settings, higher rates of trainee attrition, lack of FM in undergraduate curriculums, lack of career pathways, inappropriate de-ployment, and a lack of a critical mass. Conclusions: Support from national stakeholders, the recognition of FPs as specialists, and sustainable international collaboration promote FM programmes. The absence of a defined role within the healthcare system, low numbers of FM faculty, a poor presence in undergraduate curriculum, high attrition rate of trainees and the lack of a critical mass limit FM programmes. The standardisation of the role of FM and the implementation of undergraduate and postgrad-uate FM programmes with national and international collaboration could enable FM to reach a critical mass and realise its full potential in strengthening primary healthcare in SSA.

Publication metadata

Author(s): Davies ML, Ellis PK, Moses A, Lawson H, Akpalu A, Walker RW

Publication type: Article

Publication status: Published

Journal: Ghana Medical Journal

Year: 2022

Volume: 56

Issue: 4

Pages: 311-321

Print publication date: 01/09/2022

Online publication date: 01/12/2022

Acceptance date: 02/04/2022

Date deposited: 18/05/2023

ISSN (print): 0016-9560

ISSN (electronic): 2616-163X

Publisher: Ghana Medical Association


DOI: 10.4314/gmj.v56i4.10


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