Taking the battle against disease into the family home
The fight for the health and wellbeing of South Africans should be taken into the homes of the neediest individuals and families, believes Professor Jannie Hugo, Head of the Department of Family Medicine at the University of Pretoria.
Prof Hugo, who is also an award-winning doctor and a member of the Chronic Disease Initiative for Africa, is a passionate advocate for Community-oriented Primary Care (COPC) – a proven approach to primary care according to which healthcare is brought proactively to families and individuals where they live, work and play.
‘Our current healthcare system focuses too much on the swamped hospitals and clinics where doctors and nurses are struggling to keep people from dying. We need to move our efforts to where the epidemics (like tuberculosis (TB), HIV, diabetes and hypertension) are, in communities, where people are at risk and may unknowingly be spreading diseases and getting infected,’ says Professor Hugo.
In 2013 Professor Hugo and his team won the Council of Higher Education Learning and Teaching Association of South Africa’s first ever National Excellence in Teaching Award for their innovative platform to serve the educational needs of undergraduate and postgraduate medical and clinical associate students, while at the same time providing excellent primary healthcare, training community workers through peer learning and improving the lives of thousands of people.
There is proof that COPC works. The programme was piloted in eight municipal wards in Tshwane between 2011 and 2013, and it was found that up to half of people with presumed TB and almost half of those diagnosed with TB were not in contact with health departments or authorities and did not even know about health facilities in their area. COPC changed this by appointing team leaders and community healthcare workers who followed up, sent people for testing, started those in need on TB medication, and organised family screening, thereby significantly changing the model of care for these communities.
‘For us, COPC is not a programme but a revolution in the paradigm of health service delivery. It is something different and we are proud and excited to be part of it,’ says Professor Hugo. ‘This revolution is about placing ourselves in the communities. If we work with community health workers and ordinary individuals and families, we can break the stranglehold of disease together,’ he said.
Professor Hugo believes working with the CDIA – the country’s foremost chronic diseases research grouping – will be hugely beneficial. ‘The CDIA has done much work in communities and at clinics and health centres and with our experience with COPC, particularly in the practice of setting up and operating at community level and in family homes, we can help set up a comprehensive plan for reaching and helping more people in need.’
‘If we were able to put all our resources and common knowledge into one system, that could be very powerful,’ says Professor Hugo. He was present at a recent high-level meeting in Pretoria, also attended by CDIA Director Professor Naomi Levitt and other healthcare stakeholders to discuss combining approaches and synergising efforts to better address chronic disease management.
The CDIA has done a significant amount of work at community level, especially in the field of primary healthcare and providing models of care and guidelines for community workers. ‘We need more partnerships and more collaboration across all sectors of our healthcare system to change the picture of disease in South Africa. We are delighted to be working with Professor Jannie Hugo and the University of Pretoria,’ says Professor Levitt.
‘I believe it will help us to reach more people and significantly change our approach to primary care and chronic diseases in this country,’ she says.