Review Article

The contribution of family physicians to African health systems

Robert Mash
African Journal of Primary Health Care & Family Medicine | Vol 14, No 1 | a3651 | DOI: | © 2022 Robert Mash | This work is licensed under CC Attribution 4.0
Submitted: 05 May 2022 | Published: 28 July 2022

About the author(s)

Robert Mash, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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Background: Africa is the last region to incorporate family physicians into its health systems. They are still a relatively new concept in many countries, small in numbers and deployed in a variety of ways. There is a need for more evidence on their contribution to African health systems to guide policymakers.

Aim: The aim of this study was to review the special collection of short reports on the contribution of family physicians to African health systems, published in the African Primary Health Care and Family Medicine Journal in 2021.

Method: Seventeen short reports from eight countries were qualitatively and thematically analysed in ATLAS.ti. Codes, which were derived inductively, were organised into categories according to the World Health Organization’s primary health care monitoring framework.

Results: In the domain of health system determinants, family physicians made little contribution to governance, adjustment to population health needs or financing. They did, however, contribute substantially to the capacity of the health workforce, supply of equipment, functioning of the health information system and use of digital technologies. In the domain of service delivery, they strengthened the model of care and championed systems for improving the quality of care. This translated into improved availability and utilisation of services, core functions of primary care, quality of care and patient safety.

Conclusion: Family physicians described their important contribution to service delivery in district hospitals and primary health care. This should lead to improvements in outcomes and impact for the health system. Their contribution to the concept of resilient facilities and health services needs further exploration.


family physicians; Africa; service delivery; health workforce; quality improvement; models of care; primary health care


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1. Perceptions of specialists in the public sector, on the role and value of family medicine
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doi: 10.4102/safp.v64i1.5628