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Open Forum - Special Collection: Reflecting on the Past and Shaping the Future
Clinical leadership development: Current practices and future directions for Southern African primary healthcare
Submitted: 09 December 2025 | Published: 27 February 2026
About the author(s)
Richard Cooke, Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaAngela de Sá, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Louis S.P. Jenkins, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Primary Health Care Directorate, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Department of Family and Emergency Medicine, George Hospital, Western Cape Department of Health, George, South Africa
Ramprakash Kaswa, Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
Klaus B. von Pressentin, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Abstract
Family physicians are uniquely positioned to lead efforts to tackle Southern Africa’s persistent primary healthcare challenges, yet such leadership is often perceived as a top-down process rather than a tangible presence. Drawing on insights from the 2025 South African Academy of Family Physicians (SAAFP) conference workshop, we synthesised leadership behaviours, innovative curricula, and workplace learning approaches, aligning with Entrustable Professional Activities and national unit standards. We outline a 5-year roadmap for clinical trainers, programme leaders, and the SAAFP, including: creating psychologically safe learning environments; embedding 360° feedback; normalising mindfulness and reflective practice; and leveraging mentorship for early-career family physicians.
Contribution: This Open Forum contributes to the South African Family Practice journal’s 45-year special collection by reflecting on significant milestones and proposing future directions for clinical leadership and governance. Practical strategies are offered to embed leadership presence, mentorship, and a culture of feedback into training programmes and health system strengthening activities.
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