Email this article 
Hide
Show all
Review Article
The contribution of family physicians to African health systems
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 AfricaAbstract
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.
Keywords
Metrics
Total abstract views: 4077Total article views: 6139
Crossref Citations
1. District health service delivery and the contribution of family physicians
Robert Mash, Jenny Nash
South African Journal of Science vol: 120 issue: 11/12 year: 2024
doi: 10.17159/sajs.2024/18712
2. Understanding implementation research
Robert Mash, Juliet Nyasulu, Zelra Malan, Lisa Hirschhorn
African Journal of Primary Health Care & Family Medicine year: 2025
doi: 10.4102/phcfm.v17i2.4934
3. Registrars’ experience with research in family medicine training programmes in South Africa
Emcy Louw, Robert J. Mash
South African Family Practice vol: 66 issue: 1 year: 2024
doi: 10.4102/SAFP.v66i1.5907
4. Perceptions of specialists in the public sector, on the role and value of family medicine
Rihangwele Mukhinindi, Andrew J. Ross
South African Family Practice vol: 64 issue: 1 year: 2022
doi: 10.4102/safp.v64i1.5628
5. Family physicians as advocates for primary health care in Botswana
Billy M. Tsima, Yaone Bogatsu, Keneilwe Motlhatlhedi, Claire Brockbank, Sunanda C. Ray
African Journal of Primary Health Care & Family Medicine vol: 17 issue: 1 year: 2025
doi: 10.4102/phcfm.v17i1.4908
6. Policy and service delivery proposals to improve primary care services in low-income and middle-income country cities
Richard J Lilford, Benjamin Daniels, Barbara McPake, Zulfiqar A Bhutta, Robert Mash, Frances Griffiths, Akinyinka Omigbodun, Elzo Pereira Pinto, Radhika Jain, Gershim Asiki, Eika Webb, Katie Scandrett, Peter J Chilton, Jo Sartori, Yen-Fu Chen, Peter Waiswa, Alex Ezeh, Catherine Kyobutungi, Gabriel M Leung, Cristiani Machado, Kabir Sheikh, Sam I Watson, Jishnu Das
The Lancet Global Health vol: 13 issue: 5 first page: e954 year: 2025
doi: 10.1016/S2214-109X(24)00536-9
7. Investment in family medicine to improve health outcomes in sub-Saharan Africa
Sunanda C. Ray, Mpundu Makasa, Innocent Besigye, Jacob S. Shabani, Martha Makwero
African Journal of Primary Health Care & Family Medicine vol: 17 issue: 1 year: 2025
doi: 10.4102/phcfm.v17i1.5033
8. Creating the evidence for family medicine advocacy in Africa
Robert J. Mash
African Journal of Primary Health Care & Family Medicine vol: 17 issue: 1 year: 2025
doi: 10.4102/PHCFM.v17i1.5269
9. Strategies for meeting needs in Hong Kong social service management: Fostering positive growth in multidisciplinary teams
Florence Kwai Ching Wong, Alex Siu Wing Chan, Shaelynn Hsu, Joseph Hin Ching Hung, Ka Tat Tsang
The British Journal of Social Work year: 2026
doi: 10.1093/bjsw/bcag084
10. Family physician deployment in South Africa’s district health system: A cross-sectional study
Theresia A. Rubler, Klaus B. von Pressentin, Robert J. Mash
South African Family Practice vol: 68 issue: 1 year: 2026
doi: 10.4102/SAFP.v68i1.6289
11. Advocacy for family medicine in sub-Saharan Africa
Robert J. Mash
African Journal of Primary Health Care & Family Medicine vol: 17 issue: 1 year: 2025
doi: 10.4102/phcfm.v17i1.5109
12. Myriad untold stories unfolding daily: South Africa’s pursuit of quality primary health care
Klaus B. von Pressentin, Ramprakash Kaswa, Shane Murphy, Arun Nair, Indiran Govender
South African Family Practice vol: 66 issue: 1 year: 2024
doi: 10.4102/SAFP.v66i1.5867
13. Stepping up in clinical governance: The leadership challenge for new family physicians
Klaus B. von Pressentin, Arun Nair, Chantelle Van der Bijl
South African Family Practice vol: 67 issue: 1 year: 2025
doi: 10.4102/safp.v67i1.6143
14. Change and Stability in the Family Physician Service System: An Evolutionary Game Approach
Li Luo, Siqi Zhang, Jie Xiang, Renbang Shan, Helen Skouteris
Health & Social Care in the Community vol: 2026 issue: 1 year: 2026
doi: 10.1155/hsc/8204660
15. Lessons learnt from advocating for family medicine in South Africa
Robert J. Mash, Klaus Von Pressentin, Jenny Nash, Tasleem Ras
African Journal of Primary Health Care & Family Medicine vol: 17 issue: 1 year: 2025
doi: 10.4102/phcfm.v17i1.4795