Clinical skills of general practitioners in Nairobi, Kenya: a cross-sectional study.
Primary care
clinical skills
comprehensive health care
family medicine
general practice
primary health care
private sector
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
09
12
2021
revised:
17
01
2022
accepted:
18
01
2022
pubmed:
9
3
2022
medline:
9
3
2022
entrez:
8
3
2022
Statut:
epublish
Résumé
Quality service delivery in primary care requires motivated and competent health professionals. In the Kenyan private sector, GPs with no postgraduate training in family medicine offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in Kenya. To evaluate GPs' training and experience in the skills required for comprehensive primary care. A cross-sectional descriptive survey in 13 primary care clinics in the private sector of Nairobi, Kenya. A questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed using the Statistical Package for Social Sciences (SPSS, version 25). GPs were mostly aged <40 years, with ≤10 years of experience, and there was an equal sex distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear, nose, and throat (ENT) and eyes, women's health, and orthopaedics. The GPs lacked training in specific skills such as proctoscopies, contraceptive devices, skin procedures, intra-articular injections, red reflex tests, and use of genograms. GPs lacked training and performed poorly in some of the essential skills required in primary care. Continuing professional development, training in family medicine, broadening the model of care, and deployment of family physicians to the clinics could improve care comprehensiveness.
Sections du résumé
BACKGROUND
BACKGROUND
Quality service delivery in primary care requires motivated and competent health professionals. In the Kenyan private sector, GPs with no postgraduate training in family medicine offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in Kenya.
AIM
OBJECTIVE
To evaluate GPs' training and experience in the skills required for comprehensive primary care.
DESIGN AND SETTING
METHODS
A cross-sectional descriptive survey in 13 primary care clinics in the private sector of Nairobi, Kenya.
METHOD
METHODS
A questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed using the Statistical Package for Social Sciences (SPSS, version 25).
RESULTS
RESULTS
GPs were mostly aged <40 years, with ≤10 years of experience, and there was an equal sex distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear, nose, and throat (ENT) and eyes, women's health, and orthopaedics. The GPs lacked training in specific skills such as proctoscopies, contraceptive devices, skin procedures, intra-articular injections, red reflex tests, and use of genograms.
CONCLUSION
CONCLUSIONS
GPs lacked training and performed poorly in some of the essential skills required in primary care. Continuing professional development, training in family medicine, broadening the model of care, and deployment of family physicians to the clinics could improve care comprehensiveness.
Identifiants
pubmed: 35256356
pii: BJGPO.2021.0233
doi: 10.3399/BJGPO.2021.0233
pmc: PMC9680751
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2022, The Authors.
Références
Br J Gen Pract. 2010 Apr;60(573):286-92
pubmed: 20353673
Prev Med. 2005 May;40(5):595-601
pubmed: 15749144
Asia Pac Fam Med. 2018 May 29;17:4
pubmed: 29853781
BMJ. 2014 Nov 11;349:g6485
pubmed: 25389154
Hum Resour Health. 2015 Dec 04;13:93
pubmed: 26637305
Aust Fam Physician. 2009 Jan-Feb;38(1-2):66-70
pubmed: 19283240
S Afr Fam Pract (2004). 2020 Oct 22;62(1):e1-e12
pubmed: 33179953
BMC Fam Pract. 2011 Jul 04;12:67
pubmed: 21726454
BMC Health Serv Res. 2010 Mar 13;10:65
pubmed: 20226084
Bull World Health Organ. 2010 Dec 1;88(12):943-8
pubmed: 21124720
Lancet. 2016 Aug 6;388(10044):606-12
pubmed: 27358251
BMC Fam Pract. 2019 Dec 1;20(1):165
pubmed: 31787078
BMC Fam Pract. 2021 Feb 17;22(1):39
pubmed: 33596838
Afr J Prim Health Care Fam Med. 2018 Oct 04;10(1):e1-e7
pubmed: 30326721
Can Fam Physician. 2015 Jul;61(7):596-600
pubmed: 26380849
Int J Qual Health Care. 2008 Oct;20(5):308-13
pubmed: 18055502
Hum Resour Health. 2014 Jan 21;12:3
pubmed: 24443978
Fam Pract. 2014 Aug;31(4):427-36
pubmed: 24857843
Afr J Prim Health Care Fam Med. 2020 Sep 21;12(1):e1-e4
pubmed: 33054269
BMC Fam Pract. 2018 Nov 29;19(1):186
pubmed: 30497398
Afr J Prim Health Care Fam Med. 2016 May 19;8(1):e1-e12
pubmed: 27247157
Afr J Prim Health Care Fam Med. 2014 Dec 01;6(1):E1
pubmed: 26245386
BMJ Glob Health. 2019 Sep 13;4(Suppl 8):e001496
pubmed: 31565424