Short Report – Special Collection: African Health Systems

The contribution of family physicians to surgical capacity at district hospitals in South Africa

Hans Hendriks, Adeloye Adeniji, Louis Jenkins, Robert J. Mash
African Journal of Primary Health Care & Family Medicine | Vol 13, No 1 | a3193 | DOI: https://doi.org/10.4102/phcfm.v13i1.3193 | © 2021 Hans Hendriks, Adeloye Adeniji, Louis Jenkins, Robert J. Mash | This work is licensed under CC Attribution 4.0
Submitted: 13 August 2021 | Published: 27 October 2021

About the author(s)

Hans Hendriks, Harry Surtie Hospital, Northern Cape Government: Health, Upington, Northern Cape, South Africa; and, Department of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Adeloye Adeniji, Ceres Hospital, Western Cape Government: Health, Ceres, South Africa; and, Department of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Louis Jenkins, George Hospital, Western Cape Government: Health, George, South Africa; and, Department of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Robert J. Mash, Department of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

The World Health Organization states that essential, cost-effective surgical care should be delivered at district hospitals. In South Africa significant skills gap exist at district hospitals, particularly in the area of surgery and anaesthesia. These small to moderate sized hospitals are too small to support a range of full time specialists even if they could be recruited and were cost-effective. Family physicians (FPs) are trained in the clinical skills required for district hospitals and primary health care. Clinical associates have also been introduced to perform procedures at district hospitals. This report illustrates the contribution of a FP to surgical care at Zithulele Hospital in the Eastern Cape. Family physicians not only bring the necessary clinical skills set but also increase the confidence and capacity of the whole team. Outreach and support by surgeons, as well as continuing professional development, are important. Surgical and anaesthetic skills must be developed together. Family physicians also bring leadership and clinical governance skills that ensure the inputs to support surgery, such as equipment and information systems are available. The contribution of FPs to surgery and district hospitals is overlooked in both policy and practice. Human resources for health policy should recognise their contribution and increase the numbers available and FP posts at district hospitals. There is also a need to update the package of emergency and essential surgical procedures in policy.

Keywords

district hospital; district health services; district health system; family physician; surgical capacity; surgery

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