Abstract:
Background. Health-care systems based on primary health care (PHC) are more equitable and
cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge
and skills that are needed to increase quality of care. Family medicine is a relatively new spe-
cialty in sub-Saharan Africa.
Objective. To explore the extent to which the Primafamed South–South cooperative project con-
tributed to the development of family medicine in sub-Saharan Africa.
Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked
together with 10 partner universities in sub-Saharan Africa to develop family medicine training
programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and
threats) analysis was done and the training development from 2008 to 2010 in the different part-
ner universities was analysed.
Results. During the 2.5 years of the Primafamed project, all partner universities made progress
in the development of their family medicine training programmes. The SWOT analysis showed
that at both national and international levels, the time is ripe to train medical doctors in family
medicine and to integrate the specialty into health-care systems, although many barriers, includ-
ing little awareness, lack of funding, low support from other specialists and reserved support
from policymakers, are still present.
Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan
Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action
research and support from governments are necessary to develop family medicine and increase its
impact. The Primafamed project showed that development of sustainable family medicine training
programmes is a feasible but slow process. The South–South cooperation between the ten partners
and the South African departments of family medicine strengthened confidence at both national
and international levels.
