Exploring stakeholders' experiences on implementing family medicine in urban South Africa.

Abstract

Background:  South Africa recognised family medicine as a medical speciality in 2007. The discipline plays a significant role in strengthening primary health care. However, the experiences of family physicians, private general practitioners and other stakeholders on implementing family medicine in urban South Africa remain unexplored.

Aim:  To explore stakeholders' experiences in urban South Africa on implementing family medicine.

Setting:  All participants were from Gauteng province, South Africa.

Methods:  The evaluated lived experiences of implementing family medicine as a clinical discipline. A descriptive, explorative qualitative study was undertaken using semi-structured, in-depth interviews with purposively selected individuals from October 2019 to December 2020. Thematic data analysis used MAXQDA version 2020.

Results:  Four major themes emerged. Most participants felt a disparity between private and public primary care services, with the latter having optimistic views about health reforms. Further, private general practitioners' clinical skills and competencies needed strengthening, and mixed staffing for primary care teams was envisioned. Many participants had ill-defined ideas about family medicine's impact and prospects but agreed that more resources were needed to improve it.

Conclusion:  The study highlights the participants' first-hand involvement in implementing family medicine. The findings may enhance knowledge of primary care services, clinical skills and staff composition. Further research is recommended.Contribution: The study provides insight into recognising family medicine, which preceded the government's efforts to introduce Universal Health Coverage to be funded through the National Health Insurance.