title: Family medicine training in sub-Saharan Africa: South-South cooperation in the Primafamed project as strategy for development.
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 specialty in sub-Saharan Africa.
  
  
  OBJECTIVE
  To explore the extent to which the Primafamed South-South cooperative project contributed 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 partner 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, including 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.
authors.affiliation: Department of Family and Community Medicine (FAMCO), National University of Rwanda, Butare, Rwanda, Department of Family Medicine and PHC, Ghent University, Ghent, Belgium, maaike.cotc@gmail.com.
authors.forename: Maaike
authors.initials: M
authors.lastname: Flinkenflögel
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: Akye
authors.initials: A
authors.lastname: Essuman
authors.affiliation: Division of Family Medicine, Moi University, Eldoret, Kenya and.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chege
authors.affiliation: Department of Community Health and Primary Care, University of Lagos, Lagos, Nigeria.
authors.forename: Olayinka
authors.initials: O
authors.lastname: Ayankogbe
authors.affiliation: Department of Family Medicine and PHC, Ghent University, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: De Maeseneer
mesh_terms: D017954:Africa South of the Sahara; D003299:Cooperative Behavior; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005194:Family Practice / Q000193:education*; D006801:Humans; D016730:Program Development
keywords: Continuing medical education (CME); faculty development; family health; graduate medical education/fellowship training; international health.