Mohamoud Gulnaz, Mash Robert
Division of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa
Department of Family Medicine, Aga Khan University, Nairobi, Kenya.
BJGP Open. 2022 Sep 28;6(3). doi: 10.3399/BJGPO.2021.0233. Print 2022 Sep.
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.
基层医疗服务的优质提供需要积极主动且胜任工作的卫生专业人员。在肯尼亚私营部门，没有接受过家庭医学研究生培训的全科医生提供基层医疗服务。关于基层医疗服务提供者提供全面护理能力的证据匮乏，肯尼亚私营部门执业的全科医生也没有此类证据。
评估全科医生在全面基层医疗所需技能方面的培训和经验。
在肯尼亚内罗毕私营部门的13家基层医疗诊所进行的横断面描述性调查。
改编了一份最初为南非基层医疗医生全国性调查设计的问卷。该研究收集了25名全科医生关于临床技能表现的自我报告数据。使用社会科学统计软件包（SPSS，版本25）对数据进行分析。
全科医生大多年龄小于40岁，经验≤10年，且性别分布均衡。全科医生报告在成人健康、沟通与咨询以及临床管理方面表现中等；在急诊、儿童健康、外科、耳鼻喉科和眼科、妇女健康以及骨科方面表现较弱。全科医生缺乏诸如直肠镜检查、避孕器具、皮肤操作、关节内注射、红光反射检查以及使用系谱图等特定技能的培训。
全科医生缺乏培训，在基层医疗所需的一些基本技能方面表现不佳。持续专业发展、家庭医学培训、拓宽护理模式以及向诊所派遣家庭医生可提高护理的全面性。
