Family medicine in Denmark: Are there lessons for Botswana and Africa?

Abstract

Family medicine is a new specialty in Botswana and many African countries and its definition and scope are still evolving. In this region, healthcare is constrained by resource limitation and inefficiencies in resource utilisation. Experiences in countries with good health indicators can help inform discussions on the future of family medicine in Africa. Observations made during a visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice of family medicine and the role of support staffin a family practice were often different and sometimes unimaginable by African standards. Danish family practices were friendly and enmeshed in an egalitarian and efficient health system, which is supported by an effective information technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to more complicated patient problems. Higher taxation and higher health expenditure seemed to undergird the effective health system. An egalitarian relationship amongst patients and healthcare workers (HCW) may help improve patient care in Botswana. Task shifting should be formalised, and all sectors of primary healthcare should have fast and effective information technology systems. HCW training and roles should be revised. Higher health expenditure is necessary to achieve good health indicators.