title: What challenges hamper Kenyan family physicians in pursuing their family medicine mandate? A qualitative study among family physicians and their colleagues.
abstract: BACKGROUND
  Since 2005, Kenyan medical universities have been training general practitioners, providing them with clinical, management, teaching and research skills, in order to enhance access to and quality of health care services for the Kenyan population. This study assesses what expectations family physicians, colleagues of family physicians and policy makers have of family medicine, what expectations family physicians live up to and which challenges they face.
  
  
  METHODS
  Family physicians were observed and interviewed about their expectations and challenges concerning family medicine. Expectations among their colleagues were assessed through focus group discussions. Policy makers' expectations were assessed by analysing the governmental policy on family medicine and a university's curriculum.
  
  
  RESULTS
  Roles perceived for and performed by family physicians included providing comprehensive care, health care management, teaching, and to a lesser extent community outreach and performing research. Challenges faced by family physicians were being posted in situations where they are regarded as just another type of specialist, lack of awareness of the roles of family physicians among colleagues, lack of time, lack of funds and inadequate training.
  
  
  CONCLUSIONS
  The ministry's posting policy has to be improved to ensure that family physicians have a chance to perform their intended roles. Creating an environment in which family physicians can function best requires more effort to enlighten other players in the health care system, like colleagues and policy makers, about the roles of family physicians.
authors.affiliation: Faculty of Health, Medicine and Life Sciences, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands. chielvandervoort@gmail.com
authors.forename: Chiel T M
authors.initials: CT
authors.lastname: van der Voort
authors.forename: Geraldine
authors.initials: G
authors.lastname: van Kasteren
authors.forename: Patrick
authors.initials: P
authors.lastname: Chege
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Dinant
mesh_terms: D002321:Career Choice; D002983:Clinical Competence; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000193:education / Q000523:psychology* / Q000592:standards; D011050:Policy Making; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D017149:Private Sector / Q000191:economics; D024382:Professional Role; D017150:Public Sector / Q000191:economics; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000592:standards*; D012456:Salaries and Fringe Benefits; D012649:Self Concept; D000078329:Workforce