The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review

<h4>Introduction</h4> In sub-Saharan Africa (SSA), the physicians’ ratio is increasing. There are clear indications that many of them have opted to work at the first-line of healthcare delivery systems, i.e. providing primary care. This constitutes an important change in African healthca...

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Autores principales:	Kéfilath Bello, Jan De Lepeleire, Jeff Kabinda M., Samuel Bosongo, Jean-Paul Dossou, Evelyn Waweru, Ludwig Apers, Marcel Zannou, Bart Criel
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/489b3cb66afe4a64a8a8c7d5063a750d
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spelling	oai:doaj.org-article:489b3cb66afe4a64a8a8c7d5063a750d2021-11-04T06:07:12ZThe expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review1932-6203https://doaj.org/article/489b3cb66afe4a64a8a8c7d5063a750d2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535187/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4> In sub-Saharan Africa (SSA), the physicians’ ratio is increasing. There are clear indications that many of them have opted to work at the first-line of healthcare delivery systems, i.e. providing primary care. This constitutes an important change in African healthcare systems where the first line has been under the responsibility of nurse-practitioners for decades. Previous reviews on primary care physicians (PCPs) in SSA focused on the specific case of family physicians in English-speaking countries. This scoping review provides a broader mapping of the PCPs’ practices in SSA, beyond family physicians and including francophone Africa. For this study, we defined PCPs as medical doctors who work at the first-line of healthcare delivery and provide generalist healthcare. <h4>Methods</h4> We searched five databases and identified additional sources through purposively selected websites, expert recommendations, and citation tracking. Two reviewers independently selected studies and extracted and coded the data. The findings were presented to a range of stakeholders. <h4>Findings</h4> We included 81 papers, mostly related to the Republic of South Africa. Three categories of PCPs are proposed: family physicians, “médecins généralistes communautaires”, and general practitioners. We analysed the functioning of each along four dimensions that emerged from the data analysis: professional identity, governance, roles and activities, and output/outcome. Our analysis highlighted several challenges about the PCPs’ governance that could threaten their effective contribution to primary care. More research is needed to investigate better the precise nature and performance of the PCPs’ activities. Evidence is particularly needed for PCPs classified in the category of GPs and, more generally, PCPs in African countries other than the Republic of South Africa. <h4>Conclusions</h4> This review sheds more light on the institutional, organisational and operational realities of PCPs in SSA. It also highlighted persisting gaps that remain in our understanding of the functioning and the potential of African PCPs.Kéfilath BelloJan De LepeleireJeff Kabinda M.Samuel BosongoJean-Paul DossouEvelyn WaweruLudwig ApersMarcel ZannouBart CrielPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kéfilath Bello Jan De Lepeleire Jeff Kabinda M. Samuel Bosongo Jean-Paul Dossou Evelyn Waweru Ludwig Apers Marcel Zannou Bart Criel The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
description	<h4>Introduction</h4> In sub-Saharan Africa (SSA), the physicians’ ratio is increasing. There are clear indications that many of them have opted to work at the first-line of healthcare delivery systems, i.e. providing primary care. This constitutes an important change in African healthcare systems where the first line has been under the responsibility of nurse-practitioners for decades. Previous reviews on primary care physicians (PCPs) in SSA focused on the specific case of family physicians in English-speaking countries. This scoping review provides a broader mapping of the PCPs’ practices in SSA, beyond family physicians and including francophone Africa. For this study, we defined PCPs as medical doctors who work at the first-line of healthcare delivery and provide generalist healthcare. <h4>Methods</h4> We searched five databases and identified additional sources through purposively selected websites, expert recommendations, and citation tracking. Two reviewers independently selected studies and extracted and coded the data. The findings were presented to a range of stakeholders. <h4>Findings</h4> We included 81 papers, mostly related to the Republic of South Africa. Three categories of PCPs are proposed: family physicians, “médecins généralistes communautaires”, and general practitioners. We analysed the functioning of each along four dimensions that emerged from the data analysis: professional identity, governance, roles and activities, and output/outcome. Our analysis highlighted several challenges about the PCPs’ governance that could threaten their effective contribution to primary care. More research is needed to investigate better the precise nature and performance of the PCPs’ activities. Evidence is particularly needed for PCPs classified in the category of GPs and, more generally, PCPs in African countries other than the Republic of South Africa. <h4>Conclusions</h4> This review sheds more light on the institutional, organisational and operational realities of PCPs in SSA. It also highlighted persisting gaps that remain in our understanding of the functioning and the potential of African PCPs.
format	article
author	Kéfilath Bello Jan De Lepeleire Jeff Kabinda M. Samuel Bosongo Jean-Paul Dossou Evelyn Waweru Ludwig Apers Marcel Zannou Bart Criel
author_facet	Kéfilath Bello Jan De Lepeleire Jeff Kabinda M. Samuel Bosongo Jean-Paul Dossou Evelyn Waweru Ludwig Apers Marcel Zannou Bart Criel
author_sort	Kéfilath Bello
title	The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
title_short	The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
title_full	The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
title_fullStr	The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
title_full_unstemmed	The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review
title_sort	expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-saharan africa: a scoping review
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/489b3cb66afe4a64a8a8c7d5063a750d
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The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review

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