WONCA Africa conference Primafamed ToT workshop 25-31 In the last week of the World Organisation of Family Doctors (WONCA) organized the second regional meeting in the African region, with assistance of Primafamed partners and associates. This conference was followed by the Primafamed Training-of-Trainers workshop. WONCA Africa conference The WONCA Africa conference had around 300 participants from all over Africa. Several other non-african people joined due to their connection with universities or health care facilities in Africa. A hall full of interested people listening to the presentation of Prof. Otsyula Sunday 25 th The 2 nd WONCA Africa Regional Conference in Rustenburg was opened by the South African Minister of Health, Dr. Aaron Motsoaledi. He related the shame he felt at the Maternal Mortality statistics. He spoke of government commitment to improve this and his desire to restore hospital-based training of midwives. He saw a strong role for Family Physicians in this effort. He spoke several times of the priority within government of Primary Health Care and Family Medicine. He commented on the unacceptable inequity between private and public health care. Dr. Andrew Robinson, in his introduction of the Minister, referred to the important task of the conference of 'Africanising' Family Medicine. Monday 26 th Prof. Michael Kidd from Australia looked at the Role of Family Medicine in Africa in the 21st Century in the light of the theme of Defining Family Medicine in Africa. He supported Prof. Mfenyanas quest to go deeper into defining Family Medicine so that we are reading off the same page and move towards strong integrated PHC services. Prof Kidd spoke of the African need for Family Medicine as central to Primary Care but one that needs to adapt to respond to the needs in Africa. He quoted Barbara Starfield s evidence that family physicians improve outcomes and urged delegates to be the change we seek. Prof. Otsyula from Kenya spoke frankly, in Fanonist tradition, on colonialism and neo colonialism. He urged Family Medicine to be defined in an
authentic African manner and not imposed inappropriately in Africa. Prof. Bob Mash presented the Delphi Study on Defining Family Medicine in Africa. Tuesday 27 th Prof. Mustafa Khogali, of Sudan, spoke on COPC / FM training in Africa: A way forward. He pointed out the poor mortality rates, high disease burden, weak fragmented health systems and the lack of appropriately trained health care workers in Africa. He lamented the failure in Africa of achieving Millennium Development Goals (MDG s). He highlighted principles of health systems as optimizing health care and improving access and stated that this could only be achieved through primary care. He pointed that the South African situation of public-private and PHC-hospital disparities exists throughout Africa. He highlighted the inequitable focus on specialized curative services. Dr. Martha Ladipo, of Nigeria, spoke on African Family Values and Practice of Family Medicine in Africa. She spoke of the dynamic nature of family values and the fundamental differences between individualistic Western and communalistic African family values. Organizers of WONCA Africa conference and Primafamed workshop Important people from WONCA World,WONCA Africa and Primafamed Wednesday 28 th Prof. Jan De Maeseneer, of Ghent University Belgium and promoter of the Primafamed-Edulink ACP EU project, spoke on Primary Health Care and Family Medicine in Africa: at the cross-roads!. He stressed on how much Africa has to offer the world. He highlighted a changing society and the role of primary care (and Family Medicine) as a strategy to address social determinants of health by promoting equity and intersectoral action. The primary health care team and a community-oriented primary care (COPC) were key. He felt that PHC reform of health care systems will need to address hospitalo-centric and fragmented systems and develop primary care as the hub, networking with community and partners. He pointed out World Health Assembly Resolution 62.12 which included Family Physicians in the Primary Health Care team. He raised his concern for a clear role for Family Physicians in Primary Health Care Services in Africa. With input of all participants during the many workshops, the Statement of consensus on family medicine in Africa was written. This 14 page document was discussed and in a general vote all participants accepted this consensus on the last day of the conference.
Primafamed Training of Trainers workshop The Primafamed Training of Trainers Development of Departments of Family Medicine and PHC workshop Participants of the workshop are listening full interest to Dr. Scot Loeliger presenting on CanMeds Wednesday 28 th The workshop was opened by Prof. Jan De Maeseneer, the promoter of the Primafamed Edulink ACP EU project and the VLIR 2006 project. During the opening session Prof. Pierre de Villiers presented on the African Journal of Primary Health Care and Family Medicine (AJPCFM, www.phcfm.org) which was launched one year before at the first Primafamed conference in Kampala. In his presentation Research publication in an African context he spoke on the importance of open access publication, the opportunities but also the challenges. After this official opening there was a nice reception with healthy bites for all. Thursday 29 th The second day of the workshop had the theme family medicine curriculum. It started with the introduction and discussion of CanMeds, what roles should a medical expert/ family physician be able to perform and how does this fit in the African context. After this 3 workgroups discussed the family medicine curriculum, the African way. The curricula at different universities often have a big overlap, though there was also a lot of discussion about issues like length of the training; from a one-year training program in Sudan to a four-year program in several other countries, with a big difference in contents. Local coordinators of the Primafamed Edulink ACP EU project presenting their posters In the afternoon, during the poster session, several people presented posters mainly focusing on the family medicine training in the different countries and the
development of training sites. All Primafamed partners made a poster on family medicine training at their department and the development of the training in the last year with the assistance of the Edulink funding. Friday 30 th The overall theme of Friday was capacity building. Prof. Khaya Mfenyana, the president of WONCA Africa, started this morning with an impressive and inspiring presentation on patient-centered care. He told the group a few stories of patients he occurred with during his career as a doctor and used these examples to show the importance of patientcenteredness. Full with emotion he was telling and all participants were captured by his stories while you could hear Prof. Khaya Mfenyana a pin drop in the room. In the afternoon Dr Ephraim Dafiewhare gave a general presentation on quality assurance and the importance of this, also in the development of the curricula. In the workshops the focus was on assessment, both assessment of clinical skills with OSCE (Objective Structured Clinical Examination) and doctor-patient communication. Saturday 31 st The last day of the workshop had research as leading theme. Dr. Olayinka Ayankogbe gave an introduction on research and publications: Building a research culture in family practice in Africa. With a lot of personal experience of research in the context of African PHC and family medicine he gave an overview of the different steps that need to be taken to do research, starting with reading journals with use of internet, to disseminating the results. In the workshops topics like research design and methodology and grant writing were discussed. With input from the participants, useful information and advices, on how to start a research, where to get funding and how to write, were exchanged. Group picture of the participants of the Primafamed workshop
Logistics All people funded by the Primafamed Edulink ACP EU project and the VLIR 2006 project were accommodated in the Road Lodge Hotel, a few kilometers from the venue. Transport from and to the venue was done by a local taxi company with mini buses. The Edulink EU-funded Primafamed project paid for two participants per partneruniversity to attend the WONCA Africa conference and Primafamed workshop. Next to this twelve people representing the associates of the project were funded. The VLIR funded 18 people to attend. We would like to thank our sponsors Edulink ACP EU and VLIR UOS for the possibility to organize this event and let us bring all our partners together to the WONCA Africa conference and the Primafamed meeting. With all our participants this week full meetings and discussions has been very fruitful with good outcomes we can work on further in the coming year. Jan De Maeseneer Primafamed project promoter Maaike Flinkenflögel Primafamed project coordinator Conference organiser Lynn Ryssaert Conference organiser