Family medicine and primary health care: the role of undergraduate training on current practices and future considerations of junior doctors in South Africa
Date
2016-02-12
Authors
Mosam, Atiya
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction: The South African government recently began the implementation of the new
National Health Insurance (NHI) and Re-engineering of Primary Health Care (PHC) policy
proposals (green paper) in order to achieve universal health coverage and health equity. One of
the vital aspects of these policy proposals is the recruitment and retention of doctors within PHC
in the public sector. This study therefore aims to examine the training, current practices and
future intentions of doctors completing community service in 2010, 2011 and 2012 in order to
ascertain which factors may be associated with employment in PHC.
Methodology: The study was designed as a cross sectional study with an analytical component.
Doctors in the cohorts of interest were contacted via email and requested to fill in an anonymous
self-administered online survey. Univariate analysis was done to describe socio-demographic
characteristics, current employment status and future intentions. Bivariate analysis was done to
examine any associations between exposure to family medicine and PHC during undergraduate
training, internship and community service, and employment in PHC.
Results: The database yielded a sample of 350 doctors, of which 61 responded. Of the
respondents, 35.59% worked as a private general practitioner whilst 11.86% work in public PHC.
The study showed no statistically significant association between exposure to family medicine
and PHC and employment in PHC but female gender was the socio-demographic variable found
to be associated with PHC employment (p=0.02). Factors that deterred doctors from pursuing a
specialization in family medicine were related to employment conditions such as poor resources
and under staffing and not to factors related to the specialty itself such as an unchallenging scope
of work or poor professional perception of the specialty.
Conclusion: Whilst the study showed no association between exposure to family medicine and
PHC and career choices in that field, it has highlighted that the conditions within the public
service are the biggest deterrent to doctors. Thus whilst medical school admissions should aim to
increase the number of students with characteristics positively associated with PHC employment
such as female gender, it is important that the Department of Health in South Africa aims to
Mosam,
Atiya.
0003032K.
MPH
2015
ensure that the conditions within the public service are optimized in order to recruit and retain as
many doctors as possible in light of the human resource requirements of the new policy.
Description
Research Report For
Masters of Public Health
30 March 2015