In sub-Saharan Africa, both in urban and rural areas, a growing number of doctors is operating at the level of the first-line health care facilities, the latter being traditionally under the responsibility of nurse-practitioners. This appears to be also the case in Benin. Literature suggests that First-Line Medical Doctors (FLMDs) have a potential to strengthen Primary Health Care (PHC). Today, however, in most African countries, a coherent and evidence-informed policy framework to ‘steer’ the functioning of this growing number of FLMDs does not exist. Such a policy would require more and better knowledge on the current functioning and roles of FLMDs, on the tensions and even disruptions their functioning may create in existing health care delivery systems, on their current performance in terms of providing quality and equitable primary health care, and, last but not least, on the implications in terms of systems design and management for that potential to effectively realize. This project precisely aims to contribute in filling that gap. It intends study in detail the existing experiences in Benin with FLMDs’ practices, and eventually propose policies with regards to their role(s) in achieving more performant PHC systems. The study will follow a mixed-methods design. The Van Olmen’s health systems dynamics framework will guide the overall research. After an initial literature review, a crosssectional study will be conducted to map and analyze the various existing FLMD’s practices in Benin, and from thereon, empirically, establish a tentative typology of FLMD’s practices in the country. In a second phase, purposively selected case-studies of FLMDs will be carried out to evaluate their performance in terms of health care delivery. Eventually, a theory will be formulated on the conditions for FLMDs to improve PHC in Benin that will be shared and discussed with the Ministry of Health and other key stakeholders. This theory will constitute the basis for a policy framework to address, structure and regulate the role(s) and functioning of FLMDs in the Beninese health system, in a perspective of improving Primary Health Care.
|Effective start/end date||1/04/18 → …|
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