Benefits, challenges, and the way forward: medical specialists’ perception on family physician integration in healthcare system in Tanzania

Abstract

Family medicine provides comprehensive care by integrating biomedical, behavioral, and social sciences. While established in some sub-Saharan countries, it remains new and unintegrated in Tanzania’s public health system. Its integration is vital for healthcare reform to enhance patient care and system quality.This study aimed to understand the perceptions of medical specialists regarding the integration of family physicians into the Tanzanian healthcare system. A descriptive qualitative study was conducted through in-depth interviews with ten medical specialists from Aga Khan Hospital and Muhimbili National Hospital in Dar es Salaam. Thematic analysis was employed in this study. Integration of family physicians into the healthcare system was widely supported, with recognized benefits of the holistic approach that family medicine offers including improved patient outcomes, cost-effectiveness, early disease detection, and efficient management of common conditions. FPs were also acknowledged for their leadership potential and ability to address human resource gaps in primary care. However, significant challenges hinder their integration, including limited awareness among stakeholders, absence of a defined scheme of service, shortage of training institutions, and risk of underemployment among medical doctors and clinical officers. Recommendations for integration included increasing awareness and advocacy, establishing a structured scheme of service, expanding training programs, forming a Family physicians association, and engaging the Ministry of Health for policy inclusion. The strategic placement of Family physicians at district hospitals and above, along with the use of telemedicine, was proposed to maximize their impact within the healthcare system. Most specialists had a positive perception of integrating Family Physicians (FPs) into Tanzania’s healthcare system, recognizing it as a transformative opportunity to strengthen primary care, patient care and overall system quality. However, challenges such as limited awareness, the absence of a structured scheme of service, and limited training institutions hinder full recognition and deployment. Overcoming these barriers through advocacy, policy reforms, and expanded training programs is crucial for successful integration.