The Development of Family Medicine in Africa: A Panel Discussion Bruce Dahlman, M.D. M.Sc. INFA-MED Cynthia Haq M.D. U Wisconsin Jane Philpott M.D. U Toronto Calvin Wilson M.D. U Colorado

Hyatt Regency Coral Gables, Florida 9 September 2010 AAFP 2010 Family Medicine Global Health Workshop: Breakout Sessions 3 and 9 Hyatt Regency Coral Gables, Florida 9 September 2010

Objectives Discuss the historical context of the development of Family Medicine in sub-Saharan Africa Discuss the potential benefits of family medicine as a specialty in African health care systems Discuss the challenges to and strategies of successful family medicine program development Discuss the lessons learned from international collaboration for family medicine development on the continent

Rustenburg South Africa - Oct. 2009 Statement of Consensus on Family Medicine in Africa Authors: Prof. Bob Mash and Dr. Steve Reid Process: 8 themes developed at 2008 PRIMFAMED conference – Kampala; papers prepared 15 facilitated small groups discuss themes Plenary session consensus vote on statements Source: Journal of African Family Medicine and Primary Care. Vol 2: 1 Article 151 www.phcfm.org

Themes of African Family Medicine 1. The contribution of Family Medicine to equity in health care (9 statements) 1.8. “Family Medicine should contribute to quality care that is not threatened by commercialisation, or by weak services in the public sector.” 2. Family Medicine and primary health care (8) 2.3 “The clinical practice of Family Medicine is integral to the district health system and includes care at community, clinic, health centre and hospital levels”.

Themes of African Family Medicine 3. The role of the African Family Physican (13) 3.1 “In an African context, the family physician is a clinical leader and consultant in the primary health care team, ensuring primary, continuing, comprehensive, holistic and personalised care of high quality to individuals, families and communities. The African context and community 4. African context and community (8) 4.1. “Family Medicine is community-based and must be embedded in all settings within the District Health System.”

Themes of African Family Medicine 5. Quality of Family Medicine practice in Africa (6) 5.2 “Family physicians should perform regular reviews and audits to enable reflection on their work and service, . . .” 6. Family physician training in sub-Saharan Africa 6.8 “Training should have a strong academic (21) (university-based) foundation.” 6.5. “Research must be included in all graduate programmes.”

Themes of African Family Medicine 7. Women in Family Medicine in Africa (6) 7.2. “All family physicians need to be advocates for gender equality” 7.3. “The Life Care Model adopted by WONCA internationally should be promoted in Africa” 8. Nomenclature 8.2. “A family physician has postgraduate training in Family Medicine. The term ‘family physician’ should be the nomenclature in Africa.”

Country Case Studies: Presenters Uganda: Dr. Haq Kenya: Dr. Dahlman Rwanda: Dr. Wilson Ethiopia: Dr. Philpott

Country Case Studies: Aspects Potential benefits of developing FM programs Common challenges Successful enablers Place of the family physician in the health care system Lessons from international collaboration

Panelists Discussion

Audience reflection and discussion

Highlighted conclusions/suggestions 1. 2. 3. 4.

Future explorations

Thank you for your participation!