Theresia A Rubler, Klaus B Von Pressentin, Robert J Mash
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引用次数: 0
Abstract
Background: Family physicians (FP) strengthen the quality of district health services. The South African Academy of Family Physicians (SAAFP) recommended that, by 2030, there be one FP per district hospital, community health centre or subdistrict without a community health centre. This study aimed to evaluate progress towards achieving the SAAFP's goals.
Methods: A cross-sectional, descriptive survey collected data from senior academics in family medicine at all ten universities for 2024. Data focused on the presence, number and characteristics of employment of FPs across all 52 districts, 242 subdistricts and 607 district health facilities. Descriptive and mixed-effects regression analyses were used.
Results: South Africa achieved 18.9% of the SAAFP goals, with enormous variability between provinces. Gauteng achieved 55% coverage, while the Northern Cape had no coverage. The Western Cape (34.5%) and Limpopo (23.4%) exceeded that national average. Family physicians were more likely to be employed in district hospitals (odds ratio [OR] 8.5; 95% confidence interval [CI]: 4.1-17.4, p 0.001) and metropolitan districts (OR 20.9; 95% CI: 4.0-109.4, p 0.001). Approximately 1 in 10 held medical officer posts (11.7%), and almost all were employed full time (96.3%). A substantial number (40.7%) were joint staff with universities.
Conclusion: The deployment of FPs within the district health system has expanded but remains limited relative to SAAFP goals, with ongoing inequities in distribution. Achieving the goals is possible with the commitment of national and provincial policymakers and of human resources for health planners.Contribution: This study provides the first national mapping of FP distribution in the district health system, offering critical insights for workforce planning and policy implementation in support of universal health coverage.
期刊介绍：
South African Family Practice (SAFP) is a peer-reviewed scientific journal, which strives to provide primary care physicians and researchers with a broad range of scholarly work in the disciplines of Family Medicine, Primary Health Care, Rural Medicine, District Health and other related fields. SAFP publishes original research, clinical reviews, and pertinent commentary that advance the knowledge base of these disciplines. The content of SAFP is designed to reflect and support further development of the broad basis of these disciplines through original research and critical review of evidence in important clinical areas; as well as to provide practitioners with continuing professional development material.
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