Executive summary
South Africa has an urgent need to improve the quality of district health services. Following the creation of the new speciality of family medicine in 2007, the introduction of family physicians to the district health services was an important intervention. A body of research now exists on the initial impact of family physicians on the district health services.
Family physicians have had an
impact through their six roles: clinicians, consultants, capacity builders, leaders
of clinical governance, supporters of community-orientated primary care and clinical trainers. Their impact in these roles is seen as substantial, significantly greater than medical officers and similar in both district hospitals and primary care as well
as rural and metropolitan areas. They have improved access to and the comprehensiveness of care at the community level. They have also had an impact on clinical processes for chronic diseases, maternal and child health as well as emergency care. Their impact on district and national health indicators is not yet visible due to the small numbers currently available (0.03 per 10,000 population in public sector).
The health services need to employ family physicians at district hospitals and community health centres or sub-districts. The supply
of family physicians needs to be increased by doubling the number of registrar posts from an average of 5 per year per training programme to 10 per year per training programme.
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