CPD “Family Medicine in African PHC” 3pm CAT 3 Mar

See Prof Shabir Moosa, a family physician from Johannesburg Health District – Wits University, South Africa, talk about the “Family Medicine in African Primary Health Care” at 3 pm on Thursday 3rd March 2022 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This is accredited for CPD across Africa and accessible via World Continuing Education Alliance. See post here

Join AfroPHC (and indicate your interest) and you will be sent login details within a week. Recordings will be available on the WCEA app. See details on accessing WCEA here.

Tackling the first COVID-19 wave at the Cape Town Hospital of Hope: Why was it such a positive experience for staff?

Background In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed ‘Hospital of Hope’ was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town.

Methods We aimed to systematically describe and assess the effects on staff and the local health system. A cross-sectional descriptive study design was employed using mixed methods including record reviews and interviews with key informants.

Results Quantitative results confirmed high job satisfaction and low staff infection rates. The emerging themes from the qualitative data are grouped around a “bull’s eye” of the common purpose of person-centredness, from both patient and staff perspectives, and include staff safety and support, rapid communication, continuous learning and adaptability, underpinned by excellent teamwork. The explanations for the positive feedback included good disaster planning, adequate resources, and an extraordinary responsiveness to the need.

Conclusions The ‘Hospital of Hope’ staff experience produced significant learnings for the design and management of routine health services outside of a disaster situation. The adaptability and responsiveness of the facility and its staff was largely a product of the unprecedented nature of the pandemic, but such approaches could benefit routine health services enormously, as individual hospitals and health facilities realize their place in a system that is ‘more than the sum of its parts’.

CPD “Post-Partum Haemorrhage” 3pm CAT 24 Feb

See Dr John Kabibu, a doctor from The Institut Médical Chrétien du Kasai (IMCK), or Christian Medical Institute of Kasai, talk about the “Post-Partum Haemorrhage” at 3 pm on Thursday 24th February 2022 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This is accredited for CPD across Africa and accessible via World Continuing Education Alliance.

Join AfroPHC (and indicate your interest) and you will be sent login details within a week. Recordings will be available on the WCEA app. See details on accessing WCEA here.

Community-oriented primary care for National Health Insurance in South Africa

This is a report on Chiawelo Community Practice (CCP) in Ward 11, Soweto, South Africa, a community-oriented primary care (COPC) model for National Health Insurance (NHI) in South Africa, developed by a family physician. A shift to capitation contracting for primary health care (PHC) under NHI will carry risk for providers – both public and private, especially higher number of patient visits. Health promotion and disease prevention, especially using a COPC model, will be important. Leading the implementation of COPC is an important role for family physicians in Africa, but global implementation of COPC is challenged. Cuba and Brazil have implemented COPC with panels of 600 and 3500, respectively. The family physician in this report has developed community practice as a model with four drivers using a complex adaptive system lens: population engagement with community health workers (CHWs), a clinic re-oriented to its community, stakeholder engagement and targeted health promotion. A team of three medical interns: 1 clinical associate, 3 nurses and 20 CHWs, supervised by the family physician, effectively manage a panel of approximately 30 000 people. This has resulted in low utilisation rates (less than one visit per person per year), high population access and satisfaction and high clinical quality. This has been despite the challenge of a reductionist PHC system, poor management support and poor public service culture. The results could be more impressive if panels are limited to 10 000, if there was a better team structure with a single doctor leading a team of 3–4 nurse/clinical associates and 10–12 CHWs and PHC provider units that are truly empowered to manage resources locally…..more

The influence of Continuous Quality Improvement on healthcare quality: A mixed-methods study from Zimbabwe

In an effort to improve the poor quality of maternal, newborn, and child health services, the Zimbabwe Ministry of Health and Child Care implemented a Continuous Quality Improvement (CQI) pilot in 2016. Health workers and district managers were trained and supported to implement cycles of quality target setting, developing and implementing action plans, and tracking outcomes. The pilot was implemented in district hospitals and primary health centers in five districts as an arm of the performance-based health financing (PBF) program. This study uses mixed methods to estimate the effect of the CQI model on quality of care for various services and to identify factors that enabled or impeded quality improvements. We assessed changes in quality of care for seven services over a two-year implementation period and compared these changes against other PBF districts. We also conducted focus group discussions and in-depth interviews with district and facility-level health workers and managers after implementation to explore enabling and impeding factors affecting program performance. Among the seven services assessed, CQI was associated with quality improvement in primary health centers for two: postnatal care and maternal delivery care. Enabling factors included strengthened leadership, teamwork and joint decision-making at facilities; and supportive supervision. Impeding factors included fragmentation of quality assurance policies; staff shortages and turnover; and gaps in the CQI training. Improvements were limited when considering the full breadth of potential outcomes but arise in certain areas of core focus of the CQI program. In order to see large scale improvement in the quality of healthcare in Zimbabwe, CQI should be seen as one potential tool in a broader health systems quality improvement strategy…..more

Introducing The Lancet Global Health Commission on financing primary health care: putting people at the centre

Primary health care (PHC) is an essential component of high-performing health systems, delivering effective, affordable, and inclusive care to people when they need it, and providing the foundation for both universal health coverage and the Sustainable Development Goals. As the platform for providing basic health services and essential public health functions, and for responding to the ongoing challenges of infectious disease and to the rapidly expanding burden of chronic conditions, PHC has a commitment to equity and social justice. Policymakers worldwide are seeking to strengthen their primary care systems to secure the health of their populations across the lifecourse……more

Explore AfroPHC chapters in West Africa 1-3pm WAT Fri 18th Feb

AfroPHC is keen to develop Chapters in different countries across Africa to advance the agenda of AfroPHC and get local PHC team leaders to work together, engage with key stakeholders and action simple projects locally. 

The AfroPHC Executive Board has laid out a schedule of meetings over 2022 to support this development. See here. It will run 2-4pm Central Africa Time on the 3rd Friday of every month. All AfroPHC Executive Board members will be there. 

Our first meeting for West Africa will be 1-3pm West Africa Time Friday 18th February 2022. See local time here. All AfroPHC members (and anyone else) from the following countries are invited: Nigeria, Ghana, Niger, Guinea, Benin, Burundi, Togo, Sierra Leone, Liberia, Mauritania, Gambia, Cote d’Ivoire, Burkina Faso, Mali, Senegal. There will be French translation. Please feel free to share this with other colleagues in these countries. 

Go to to the Chapter Webpage to find the calendar invite and zoom link to join the meeting.

CPD “Hypertension in Pregnancy” 3pm CAT 17 Feb

See Dr Nelisiwe Lembethe, a doctor from the District Clinical Specialist Team in Johannesburg Health District, Jhb, SA, talk about the “Hypertension in Pregnancy” at 3 pm on Thursday 17th February 2022 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This is accredited for CPD across Africa and accessible via World Continuing Education Alliance.

Join AfroPHC (and indicate your interest) and you will be sent login details within a week. Recordings will be available on the WCEA app. See details on accessing WCEA here.

WHO highlights benefits and dangers of artificial intelligence for older people

Artificial intelligence (AI) technologies can improve older people’s health and well-being, but only if ageism is eliminated from their design, implementation, and use, said the World Health Organization (WHO) on Wednesday.

In a new policy brief, Ageism in artificial intelligence for health, the agency presents legal, non-legal and technical measures that can be used to minimize the risk of exacerbating or introducing ageism through AI.

Artificial intelligence is revolutionizing many fields, including public health and medicine for older people. The technology can help predict health risks and events, enable drug development, support the personalization of care management, and much more…..more

AfroPHC Workshop 15th Feb “Rehabilitation for PHC/UHC in Africa”

AfroPHC is its second interactive AfroPHC Policy Workshop on “Exploring Rehabilitation for PHC/UHC in Africa” 1-4 pm Central Africa Time on Tuesday 15th February. Check your local time here.

Mr Jacque Chirac Awa, Project Manager of the Cameroon Baptist Convention (CBC) Health Services as well as Ms Maryke Bezuidenhout of the Africa Interprofessional Education Network (AfrIPEN) will share their insights on How we incorporate rehabilitation professionals into PHC for UHC in Africa and loosely titled “Moving beyond access: designing rehabilitation services for retention in care”

After the panel discussion of 1 hour we will break up into small groups with specific facilitators / language groups for 45 minutes to discuss the following question/s. “How do we incorporate rehabilitation professionals into PHC for UHC in Africa?” We will close the meeting with feedback and summarise key issues. We want to build discussions into the draft AfroPHC Policy Document “Building the PHC Team for UHC in Africa”. The panel and feedback will have French translations.

Please register your interest for the Policy Workshops on the AfroPHC policy page. We will provide you the zoom meeting details a few days before the meeting.

See recording of workshop and presentations below

Healthcare Information For All (HIFA) launches new strategy to accelerate progress towards universal access to reliable healthcare information

COVID-19 has underlined the urgent need to accelerate progress towards universal access to reliable healthcare information. Never before has everyone been so aware of the need for reliable healthcare information, and yet so vulnerable to misinformation.

The new HIFA Strategy 2022-2024 builds on 15 years of solid growth and achievements, including most recently a Statement from the World Medical Association in support of universal access to reliable healthcare information, representing more than 10 million doctors around the world. 

The Strategy outlines seven strategic shifts that are necessary to accelerate progress: convene stakeholders; strengthen collaboration with the World Health Organization; promote multilingualism; identify and address priority issues; harness collective intelligence; strengthen advocacy; and protect from misinformation. 

As WHO has noted: “Healthcare Information For All is an ambitious goal but it can be achieved if all stakeholders work together.” What is clearly needed now is for all stakeholders to develop and implement a global action plan to improve access to reliable healthcare information and protect people from misinformation. HIFA is ready to promote and drive this process……more

Can National Health Insurance Pave the Way to Universal Health Coverage in Sub-Saharan Africa?

Countries of sub-Saharan Africa are increasingly turning to public contributory health insurance as a mechanism to advance UHC goals. Eight countries in sub-Saharan Africa have introduced national health insurance (NHI) systems, and at least seven more have plans or have passed legislation to establish NHI. By examining the experience of countries that have taken this path, we identify some lessons about whether and how contributory NHI may or may not be a viable path toward UHC in sub-Saharan Africa…..more

Awareness of cultural practices by skilled birth attendants during pregnancy and birth in Kenya

Abstract

Cultural capacity among SBAs is recommended in maternal care to promote culturally safe care and meet the childbearing women’s cultural needs and expectations. This study aimed to explore awareness of cultural practices by skilled birth during pregnancy and birth within the Keiyo community in Kenya.

Methods

A qualitative phenomenological study was conducted between August to December 2019. A semi-structured interview guide was piloted with two SBAs. Individual interviews and data analysis were conducted iteratively. Eleven participants were interviewed, and saturation of themes was achieved after the ninth SBA. Audio recorded data were transcribed and analysed using ATLAS.ti Software version 8.4.4 (1135) that followed Van Manen’s five steps of thematic analysis.

Findings

The three themes that emerged from an inductive and iterative data analysis process were SBAs familiarity with cultural practices, SBAs awareness of cultural practices, women’s expectations of clinical care and challenges to establishing a more collaborative relationship between SBAs, traditional birth attendants (TBAs) and childbearing women.

Conclusion

The SBAs awareness of cultural practices was highlighted through relationships formed during care engagements. This awareness revealed a potential indicator for women’s choice of caregiver. Awareness of threats to cultural safety and fear of disclosure potentially created mechanisms to promote more collaborative care. A broader scope of skilled care approaches requires heightening maternity care providers’ cultural sensitisation to reduce gaps in women’s cultural needs and expectations

More

Performance-enhancing health worker supervision approaches in low- and middle-income countries

New publication shows supervision enhancements and approaches to optimizing health worker performance
A new publication illustrates how insufficient support to build, manage and optimize human resources for health in low- and middle-income countries results in inadequate health workforce performance, perpetuating health inequities and low-quality health services. A systematic review of performance-enhancing health worker supervision approaches in low- and middle-income countries was published in Human Resources for Health and assessed 57 supervision studies since 2010 in approximately 29 countries. It documents supervision enhancements and approaches that improved health worker performance and highlights components associated with these interventions’ effectiveness. Read the publication here. 

First WHO report on its work on adolescent health

Dear colleagues,

We are pleased to share with you the first ever WHO report on its work on adolescent health: Working for a brighter, healthier future. How WHO improves health and promotes well-being for the world’s adolescents
https://www.who.int/publications/i/item/working-for-a-brighter-healthier-future

WHO has progressively strengthened its work in adolescent health, growing its portfolio of research, norms and standards, country support and advocacy, and expanding the scope of work across more than 15 departments, spanning all levels of the organization to address the multifaceted needs of the global adolescent population. 

Produced by the HQ Interdepartmental Technical Working Group on Adolescent Health and Well-being, this is the first in a future series of biennial reports that describes WHO’s efforts to elevate adolescent health through collaboration and by coordinating new initiatives, expanding the scope of work and establishing ambitious objectives with its development partners and adolescents. 

You may find useful the Resource bank in Annex 2 that contains WHO resources on adolescent health including guidelines, training packages and other resources. ….more

Please disseminate widely within your networks. 

With best wishes in 2022,
On behalf of Valentina/

Valentina Baltag, MD, MSc, PhD
Unit Head, Adolescent and Young Adult Health

Department of Maternal, Newborn, Child & Adolescent Health & Ageing
World Health Organization
20 Avenue Appia
1211 Geneva 27
Switzerland

AfroPHC Executive Coordination Team

The AfroPHC Executive Coordination Team is growing as young people from across Africa are supporting work in AfroPHC and being capacitated in leadership. Watch out for the future!

I set up a small group of AfroPHC activists who I would like to groom to support me with the organisational tasks I perform as Executive Coordinator – the AfroPHC Executive Coordination Team (ECT). We have met on several occasions to build capacity as well as to help me prepare plans for the AfroPHC Executive Board to approve. A number of AfroPHC members (including from the Youth Hub) have joined. I have tried to develop them in various skills e.g. managing a website, using social media, graphic skills using free/cheap online software, managing minutes/notices, managing zoom etc.  They will be expected to voluntarily do small related tasks for AfroPHC under my direction. Hopefully they will become a pool of potential future Executive Coordinators.

Shabir Moosa

AfroPHC Executive Coordinator

CPD “Rheumatology in PHC” 3pm 9 Dec

See Dr Nirvana Bharuthram, a graduate of the University of the Witwatersrand and currently carrying out her Fellowship in the Division of Rheumatology at the Chris Hani Baragwanath Academic Hospital & the University of Witwatersrand, Jhb, SA, talk about the “Approach to Management of Common Rheumatological conditions in the Primary Health Care setting” at 3 pm on Thursday 9th December 2021 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This will be accredited for CPD for South Africa for now but we are busy arranging it via World Continuing Education Alliance for these meetings to be accredited for CPD in many African countries.

Register in advance for this webinar. After registering, you will receive a confirmation email containing information about joining the webinar. The presentation and recording will be below.

CPD “Skin Conditions” 3pm 25 Nov

See Dr Shavania Ragavan, Family Medicine Registrar, Department of Family Medicine, Johannesburg Health District & the University of Witwatersrand, Jhb, SA, talk about the “Approach to Skin Conditions in African Primary Health Care” at 3 pm on Thursday 25th November 2021 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This will be accredited for CPD for South Africa for now but we are busy arranging it via World Continuing Education Alliance for these meetings to be accredited for CPD in many African countries.

Resources

Register in advance for this webinar. After registering, you will receive a confirmation email containing information about joining the webinar. The presentation and recording will be below.

CPD “HT in Pregnancy” 3pm 11 Nov

See Dr Ann Alagidede, Family Medicine Registrar, Department of Family Medicine, Johannesburg Health District & the University of Witwatersrand, Jhb, SA, talk about the “Approach to Hypertensive Disorders for Pregnancy in African Primary Health Care” at 3 pm on Thursday 11th November 2021 in the CPD webinar of the African Forum for Primary Health Care (AfroPHC). This will be accredited for CPD for South Africa for now but we are busy arranging it via World Continuing Education Alliance for these meetings to be accredited for CPD in many African countries.

Register in advance for this webinar. After registering, you will receive a confirmation email containing information about joining the webinar. The presentation and recording will be below.

ISSHP Classification, Diagnosis, and Management Recommendations for International Practice

Hypertensive disorders in pregnancy: 2019 National guideline

 An approach to hypertensive disorders in pregnancy for the primary care physician