How to approach the implementation of PHC (Primary Health Care) in Africa, with a complex adaptive systems mindset?
AfroPHC, WONCA Special Interest Group on Complexity in Health and Towards Unity for Health (TUFH) bring together in a workshop academic researchers and those in the operational field who will outline the scholarly foundations of complexity and examples of real-time application of complexity thinking principles.
As the SARS-CoV-2 crisis and other challenges have shown, prevailing approaches to the adoption of PHC in the spirit of the Alma Ata Declaration are problematic, as much at the policy level as at the local level. The obvious question would be – if our approaches have failed, what are some of the underlying reasons, and how could it be done more effectively? This virtual workshop will focus on a different mindset – one that seeks out to understand the interconnections and interdependencies behind a systemic problem, and that a-priori explores how potential interventions may – positively and negatively – affect the system’s behaviour.
It will include a 60-90min panel, then 45 min groups in ±5 breakout rooms. Groups will then give feedback in 30-45min before we close. We want to gather the discussions to feed into the document we are crafting on “Building PHC teams for UHC in Africa”. This workshop should definitely stir interest.
The session will start with a welcome by Prof Joseph Ana (Executive Board Member). He will briefly share the development of AfroPHC with its mandate and relevant literature and policy on the African PHC/Workforce. There will then two sets of presentations
- Presenting complexity theory broadly Joachim Sturmberg and Akiko Maeda (15min each)
- Sharing insights and examples e.g. PHC Transition / PHC In SA etc – Carmel Martin / Helga Lister (15min each)
The key question for the panellists and groups should be a simple one “How do we use complexity theory to help build PHC teams for UHC in Africa?” We will try to synthesise the feedback. See the bios of the speakers below. See recordings and presentations below.
JOSEPH ANA, Professor, and Lead Senior Fellow, Africa Centre for Clinical Governance Research & Patient Safety @ HRI West Africa, Calabar, Nigeria.
As Commissioner for Health, Ministry of Health of a state in Nigeria in 2004, led the introduction of 12-Pillar Clinical Governance for Whole Health System Strengthening suitable for LMICs like Nigeria and other African Countries. Country Coordinator, PHC focused PACK Nigeria Programme (PACK=Practical Approach to Care Kit)Member, Nigeria Statutory National Tertiary Health Institutions Standards Committee. Chairman, Nigerian Medical Association (NMA) Standing Committee on Clinical Governance. Chairman, Board, Lily Hospitals Ltd, Nigeria. (COHSASA Accredited)
AKIKO MAEDA MA, Ph.D. is a Japanese/Canadian health economist with over 30 years of experience in international development in over 40 countries in the Middle East & North Africa, Central Asia, South and Southeast Asia, and Europe.
Akiko has held various positions at the World Bank, OECD, Asian Development Bank, UNICEF, and UNDP, and has managed projects in health, labor, and education sectors, including girls’ literacy and immunization programs in Yemen and Cambodia; health insurance policies and regulations in Egypt and Slovenia; and health sector labor market analyses and skills assessment for the OECD countries. Akiko also led the World Bank’s global program on Universal Health Coverage and OECD’s global health workforce strategy. She currently resides in Canada after retiring from the World Bank and is working on incorporating behavioral sciences, neuroeconomics, and complex system simulation models into health policy design and decision-making process.
Akiko has earned a Ph.D. in Health Economics from Johns Hopkins University; MA in Biochemistry & Molecular Biology and a second MA in Middle Eastern Studies from Harvard University; and BA in Biochemistry from Princeton University.
Carmel Martin, MBBS, Ph.D., MSc FRACGP FAFPHM
Chair of the WONCA Special Interest Group in Complexities in Health, and Co-Chair of the North American Primary Care Research Group, Committee of the Science of Family Medicine Complexity in Health Working Group.
Carmel is a Consultant in Community Health, Australia, and an Adjunct Associate Professor Department of Medicine, Monash University. Carmel is active in clinical general practice with a focus on chronic disease and illness, person centered care and complex unstable health journeys. Carmel is an Australian medical graduate from the University of Queensland. Carmel completed her Masters in Community Medicine at the LSHTM, University of London, and her Ph.D. at the Australian National University.
Carmel’s research in Australia, Canada and Ireland has focused on reforms related to the implementation of primary health care in complex systems, and the nature of health in body, mind, society, environment, and sense-making about personal health in each context. Carmel is co-editor, with Joachim Sturmberg, of the Forum on Systems and Complexity in Medicine and Healthcare in the Journal of Evaluation in Clinical Practice and the Handbook on Systems and Complexity in Health (Springer). Carmel has over 100 peer-reviewed journal article publications and many other publications.
Joachim Sturmberg, MBBS, DORACOG, MFM, PhD, FRACGP
Joachim is Conjoint Associate Professor of General Practice in the School of Medicine and Public Health, Faculty of Health and Medicine, at The University of Newcastle, Australia. He is a graduate of Lübeck Medical School in Germany, where he also completed his Ph.D. Since 1989, Joachim has worked in an urban group practice in the Central Coast of New South Wales.
His research focuses on understanding the complex interconnected features of health and person-centered healthcare. Together with his collaborators, Joachim proposes that a truly functional health system ought to always focus on the needs of the person/patient across all domains affecting health – local health delivery services, local and regional social and economic infrastructure and services, as well as in all portfolios at the national policy levels. These complex interdependent features of a person-centered healthcare system are described by the health vortex model.
Joachim’s current research focuses on operationalising the health vortex model, integrating the physiology of health with health care delivery, the socioeconomic domains affecting health, and the impact of policy decisions on health and the healthcare system. Joachim is the Foundation President of the International Society for System and Complexity Sciences for Healthcare. Joachim and Carmel Martin are joint co-editors in chief of the Forum on Systems and Complexity in Medicine and Healthcare as part of the Journal of Evaluation in Clinical Practice.
HELGA LISTER, Lecturer University of Pretoria, Department of Occupational Therapy and previously Lecturer at the University of KwaZulu-Natal, Department of Occupational Therapy
I believe in a more just society, using partnerships for development, being vulnerable, and that we should all work together towards improved health and well-being. My research focus areas are food security, sustainability, occupational therapy, interprofessional education and collaborative practice, trust, transport, substance use, social justice, community development, and occupational science. I am an occupational therapist with a master’s degree in development studies and currently completing my Ph.D. in public health.