Abstract:

Globally, Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) are designed to ensure equity and quality health care. In South Africa, National Health Insurance (NHI) is the vehicle for it. Strategic purchasing and contracting private general practitioners (GPs) are key strategies. Skills training will prepare GPs for NHI. However, it is not clear as to which GP skills and competencies are currently implemented in practice. The study assessed GPs’ agreement on skills and competencies in urban South Africa. A descriptive cross-sectional design and the online semi-structured survey was undertaken between 30 September to 14 October 2020. We targeted 5,212 private GPs registered on Medpages in Gauteng Province. Respondents who answered all questions were conveniently sampled. Data analysis was performed using SAS institute software, version 9.4. A four-point Likert scale was categorized as agree or disagree. A Wald Chi-square test evaluated associations between variables. Findings revealed that most had no government contract (84.3%, n=97) and were solo (53%, n=61). The majority were agreeable to the eye, ear, nose, and throat skills (93.3%, n=207). The least agreeable was the abdominal skill (32.7%, n=72). Logistic regression showed qualifications, work experience and type of practice were significant predictors. The GP contracts affected the skills range. Surveyed GPs did not agree on many listed skills. Significant predictors of an agreement to skills in the current practice were identified. The findings highlight the need to fast-track GP skills training in South Africa.

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