General practitioners’ communication skills in Nairobi, Kenya: A descriptive observational study

Background High quality primary care is associated with person-centeredness and effective communication that also supports continuity and coordination of care. In Kenya, there is little knowledge about the quality of communication in consultations by general practitioners (GPs).

Aim To evaluate the quality of communication by GPs.

Design & setting Descriptive, observational study of 23 GPs consultations in 13 private sector primary care facilities in Nairobi, Kenya.

Method One consultation with a randomly selected adult patient was recorded per GP, and 16 communication skills evaluated with the Stellenbosch University Observation Tool. A total percentage score was calculated per consultation, and compared with the GPs’ demographics, consultations’ complexity and duration using the Statistical Package for Social Sciences.

Results The GPs’ median age was 30.0 years (IQR: 29–32) and median consultation time was 7.0 minutes (IQR =3–9). Median overall score was 64.3% (IQR: 48.4–75.7). They demonstrated skills in gathering information, making and explaining the diagnosis and suggesting appropriate management. They did not make an appropriate introduction, explore the context or patient’s perspective, allow shared decision making or provide adequate safety netting. There was a positive correlation between the scores and duration of the consultations (r=0.680, P=0.001). The score was higher in consultations of moderate complexity (78.1; IQR =57.1–86.7) versus low complexity (52.2; IQR =45.1–66.6) (P=0.012).

Conclusion Consultations were brief and biomedical by young and inexperienced GPs. GPs needed further training in communication skills, particularly with regard to person-centredness. Deploying family physicians to the primary care setting would also improve the overall quality of service delivery.