See Prof Sebastian Magobotha, Orthopaedic Surgeon in University of Witwatersrand and Chris Hani Baragwanath Academic Hospital, Jhb, SA, talk about the “Management of joint pains and arthritis” at 3 pm on Thursday 22nd July 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 it to be accredited for CPD in many African countries.
Register here. Recording and slides will be below afterwards.
Join the AfroPHC Policy Workshop 1-4pm CAT on Tuesday 15th June 2021 on “Supporting Community Health Workers in the African PHC Team”. This will be in the format of a moderated discussion with panellists for 90min and then group discussion (60min) and feedback (30min). See details and register here.
The new AfroPHC Executive Board (EB) met on 7th May 2021 for the first time under the chairmanship of Dr Champion Nyoni and appointed Prof. Shabir Moosa as the first Executive Coordinator. The EB elected Dr Innocent Besigye of Uganda as President and Ms Francoise Nwabufo of Cameroon as Vice-President of the Board. The EB also filled the space vacated by Prof Moosa and the two co-options by adding Dr Marie Claire Wangari, Dr. Lizemari Hugo and Ms, Tolulope. See pic below.
A total of 210 AfroPHC members, with 164 attending on Zoom in a maximum concurrent attendance of 116, out of a registered total of 437 AfroPHC members on EngageBay voted the following nine-member AfroPHC Executive Board into place. This was after an extensive vetting of candidates at the Launch AGM.
AfroPHC had its launch AGM on 20th April 2021 where Articles of Association was adopted (with amendments) and a new nine-member Executive Board was elected by over 200 of the 350+ formal members of the African Forum for Primary Health Care. There was a wide array of candidates from across Africa, all with great stories to tell and showing the wealth of leadership available to take forward the cause of PHC and UHC in Africa. See details of AGM here
As a result of the growing relationship between WONCA Africa and WHO AFRO Dr Prosper Tumusiime joined the WONCA Africa Conference of June 2019 in Kampala, Uganda. We had a workshop with Dr Tumusiime on building the collaboration between WONCA Africa and WHO AFRO. In exploring opportunities Professor Jan de Maeseneer suggested developing an African forum for primary care, along the lines of the European Forum for Primary Care (EFPC). The EFPC was set up in 2005 as a forum of primary care providers to promote strong primary care in Europe.
This idea was explored further in the second Interprofessional Education and Collaborative Conference for Africa of the Africa Interprofessional Education Network (AfrIPEN) held in Nairobi, Kenya in August 2019. AfrIPEN is a partnership between various institutions and individual seeking to establish interprofessional education and collaborative practice (IPE) as integral part in training the health workforce and in the effective functioning of systems for health in Sub-Saharan Africa. The meeting was opportune as AfrIPEN had a multitude of various health professionals in its midst and had established a relationship with WHO AFRO, with Dr Tumusiime being at the conference as well. The idea of AfroPHC was nurtured with various leaders engaged, especially Dr Tumusiime of WHO AFRO, Dr. Champion Nyoni of AfrIPEN and Ms. Bongi Sibanda, leading the African Advanced Practice Nursing initiative. There was great enthusiasm, some basic ideas and other African PHC groups / leaders identified.
A short document sharing the vision for AfroPHC and a planned face-to-face gathering in June 2020 was developed amongst identified leadership of African frontline primary health care worker organisations in the context of the high-level UHC Declaration in September 2019. The vision essentially was to advocate for appropriate PHC and UHC in Africa by bringing together the leadership of all healthcare workers at the coalface of African primary care and ensure that we had a voice in policy on primary care (PC) / primary health care (PHC) in Africa. The plan was to develop an African Forum for Primary Health Care (AfroPHC) as the voice of the PC/PHC team and its supporters, sharing and supporting each other in advocating for PHC. The strategy was to engage each other using a Google Group and plan a face-to-face workshop in June 2020. There was instant enthusiasm with a wide range of relevant organisations joining the call, including WONCA Africa (for family doctors), African Network of Associate Clinicians (for clinical officers/associates), AAAPN Coalition (for family nurse practitioners), ICN (for nurses generally), Towards Unity For Health (for public health practitioners), AFREHealth (for health educators / researchers in Africa), AfrIPEN (for allied health professions and interprofessional practice), Primafamed (for family medicine educators), AMREF (for CHWs/community stakeholders), West African Institute of Public Health and its Academy (for public health) and WHO AFRO. They formed the AfroPHC Core Team.
Whilst the planned face-to-face AfroPHC workshop in June 2020 did not materialise due to COVID-19 there were a number of achievements over 2020. These PHC organisations (and a number of global supporters e.g. PHCPI) met monthly online as the AfroPHC Core Team. There were a series of webinars from February to May 2020 allowing the different organisations to share more about themselves and their constituencies in Africa. AfroPHC was also part of a series of webinars on COVID 19 responses. A collaboration with AMREF resulted in the offering of the online Leadership, Management and Governance of Health Systems Strengthening Course to AfroPHC constituents, garnering more than 200 participants. More recently there is a collaboration with the World Continuing Education Council to provide continuing professional development courses to constituencies. Membership sits at over 600 in the AfroPHC Google Group, serving as a communication vehicle for African PHC stakeholders.
The AfroPHC core team gelled African teamwork amongst PHC team leaders but visible PHC teamwork across Africa started with the first AfroPHC workshop over 9-11 September 2020. Dr Tumusiime, of WHO AFRO, opened the workshop. Various PHC leaders then shared their thoughts over the three three-hour sessions on getting to know the PHC Team in Africa, what the community expects from PHC in Africa and how the PHC team should function in Africa. It was billed by participants as brilliant and one of its kind, especially for its online participation and interactivity. The workshop emerged with an AfroPHC Statement that laid out key principles for the organisation. It stressed the nature of PHC as people-centred, with PHC human resources, capacity development, teamwork, inclusive PHC leadership and advocacy as key.
The resulting AfroPHC Statement was released at the AfroPHC for UHC Workshop on 10th December 2020. Mr. Jim Campbell (Director Workforce at WHO) and Dr Suraya Dalil (Director PHC at WHO) were part of the panel in this workshop, reviewing the statement and reflecting on workforce issues for PHC in Africa. This workshop also considered the development of AfroPHC as a formal organisation. A report on the UHC Workshop and further plans including the launch of AfroPHC as a formal organisation will be released shortly.
What has become plain is that PHC teamwork is taking quick shape at a high level in Africa. The various deliberations have shown that we share more than we expected. It is very possible that we will be able to produce a document on PHC Teamwork in Africa that will be tabled with WHO AFRO and that will help define the development of PHC and UHC in Africa.
WONCA Africa provides considerable leadership and material support to the development of AfroPHC. It is warming to know that this leadership by WONCA Africa is respected by all the various leaders of the PHC team in Africa. WONCA Africa and Primafamed have even been drawn into development of the Advanced Practice Nurse Training Framework in Africa. The strong cohesion of AfroPHC is respected by many stakeholders, with AfroPHC (and WONCA Africa) being drawn into a number of pan-African and global forums as an organisation that stakeholders are eager to listen to.
AfroPHC speaks to the value that the best leaders are those who build the team around them as leaders: an attribute that family physicians across Africa need to nurture as a part of their daily PHC teamwork.
Associate Professor Shabir Moosa Wonca Africa President
AfroPHC had a 3hr virtual workshop, linked to UHC Day, on 1-4 pm (Central African Time) 10th Dec 2020 to workshop the question “What is next for AfroPHC, considering the UHC movement?” We were especially concerned about workforce issues in PHC under UHC.
The workshop from 1-4 pm consisted of a plenary of 60 min, group discussions for 60 min and feedback in the next 60min on the following questions. We also wanted to explore how to set AfroPHC up as a formal organisation. See the draft AfroPHC founding document
We had 311 registrants and ±100 attendants during the 3 hr workshop. We had professions of nurse (incl. FNPs), medical doctor, public health, ambulance assistant, pharmacist, dentist, physiotherapists, medical sociologist, researchers, medical eye health attend from SA, Kenya, Uganda, Zimbabwe, Nigeria, Rwanda, Lesotho, Zimbabwe + USA, UK, Pakistan, Myanmar.
There were welcomes from global leaders:
Dr. Donald Li, World President of WONCA (World Organisation of Family Doctors) spoke of comprehensive person-centred PHC by qualified teams caring for designated populations for UHC. He was delighted by the AfroPHC work by frontline staff and urged them to show the way forward.
Ms. Thembeka Gwaga, Vice President of the International Council of Nursing (ICN) appreciated AfroPHC for its leadership. She wanted and was glad that nurses were included in the leadership e.g., Bongi Sibanda. PHC includes all practitioners and must be inclusive. WHO Report on Nursing – emphasise nursing education and workforce issues. Global shortage will worsen in Africa with migration- gear ourselves for that.
Dr. Mary Showstark, Communications Director of the International PA Educators Group (IPAG) and founder of of IFPACS for Students shared that the discipline of Physician Assistants were in 15 different countries under 14 different names across Africa. She said that PA’s were a valuable member of the PHC team and that they are looking at curriculum development and advocacy. PA’s are keen to work in interprofessional teams for patients and did not want to take other people’s jobs. She urged that different PHC disciplines cannot work in silos and wished AfroPHC well.
A key feature of the workshop was a plenary of four influential panellists who discussed how PHC activists should navigate the UHC movement and advance the vision of AfroPHC, moderated by Bongi Sibanda and Shabir Moosa
Key reflections on the AfroPHC Statement made by each of the four panellists were:
Mr. Jim Campbell: Director, Health Workforce Department at the World Health Organization welcomed the statement with the following reflections. He supported the leadership/advocacy role of AfroPHC especially as it was African (vs. regional) and inclusive of different PHC groups. He supported the language on multidisciplinary teams, as aligned to Astana/WHO language and stressed that all relevant health care workers be included especially representatives of labour to address decent work/pay issues. He shared that task-shifting was important (i.e. different occupations / scopes of practice takes on different roles) but that it was not the same as teamwork, where everyone is focused as a teamon holistic patient-centred care. On being asked whether doctors needed to be part of the PHC team he responded that the medical team was part of team to take all forward and that clinical supervision and leadership comes from specialists. He advised that we engage with healthcare worker management issues including the WHO policy on CHWs. He also advised education as lifelong learning vs training as a once-off exercise. He urged AfroPHC to engage the private sector on mixed health systems and partnerships for public purpose with government stewardship.
Dr. Suraya Dalil: Director, Special Programme on Primary Health Care at the World Health Organization congratulated Afro PHC on the creation of the forum and the statement. She shared that the history of PHC, from Alma Ata in 1978 to the Astana Declaration in 2018 (within the SDG context) had people and equity at the core. She urged well-trained well-distributed, well cared for, empowered health care workers working from prevention to rehabilitation. She said there was a need to create an enabling environment with supportive supervision, continued learning, safety at work, decent pay. She also said that gender and youth issues in human resource need to be addressed. She urged career development and progression, that we optimise quality and impact thro evidence-based policies. She urged investment in human resource and labour markets for PHC. She prioritised education with strong institutions. She felt that we need to strengthen data for human resources for PHC, noting that the healthcare workforce information system nomenclature is challenged and needs to be created. She hoped that WHO would help harmonise the different categories and disciplines in PHC. She urged that we include human resources in the private sector and to do workforce modelling, looking at gaps in delivery. She bemoaned the high unemployment of nurses. She urged that multidisciplinary teamwork in PHC goes beyond health of care, and that we liaise with networks and other disciplines e.g. education, environment, trade and community-based structures. We need to link individual care with population care (as seen needed in COVID). She urged the need to institutionalise the aligned policies at national level, including departments of finance, education and labour. She felt that we, as providers of care, are strategically located to develop trust between the state and the population. She informed the meeting of the WHA adopted the PHC Operational Framework with 14 levers (4 strategic and 10 operational lever). One of the operational levers is health workforce.
Prof. Joachim Osur: Technical Director, Amref Health Africa and Dean, School of Medical Sciences at Amref International University echoed AMREF’s support and community work. He suggested that we need actionable points and details e.g. what is team looking like and who is leading it? If we say health in all policies – is agriculture etc. also part of PHC? He urged that we engage with community systems in place (sociocultural/traditional) and don’t adopt a medical model of PHC service delivery and address financial resources for PHC: human resources, procurement etc. and raise the Abuja Declaration. He responded that healthcare workers need to be educated to manage resources. He also challenged matching the training to actual work tasks, not just diseases but psychosocial issues, thus needing comprehensive training with the multidisciplinary team based in workspace and involving others useful to intersectoral collaboration e.g. training institutions.
Dr. Prosper Tumusiime: Retired Director, Departments of Health Systems and Services Development and Universal Health Coverage & Lifecycle, WHO Regional Office for Africa appreciated the statement as it brings out principles. He stressed the need to outline aims/objectives of the forum in respect of healthcare workforce issues for UHC/PHC. He also urged that we address the multi-sectoral nature of PHC with SDGs and bring them in. He said that we need to use technology and digital health even in education. He said we needed sustainability of achievements with locally generated solutions. He urged AfroPHC to be clear and deliberate on PHC finances (both public and private) and to go beyond advocacy with actionable issues and evidenced needs in which we can track progress and find gaps in what we agreed. In response to questions on decentralised funding he share that in the past planning was done at ministry level with the periphery just receiving what was sent, not being part of planning. He urged that it was important to identify real requirements at grassroots level and quantify that to inform plans. He also urged empowerment of lower levels with funds to use but that this needed capacity and clear roles that removed layers of bureaucracy and was in accordance with the financial situation in the country. He said this needed support for better financial management but would create better accountability and involve local people. He said that the ministries of finance should also use this to raise money locally. He urged working groups around holistic PHC, Primary Care links to Secondary and Tertiary care, Research and Resources as part of planning.
There were also announcements of the 30by2030 campaign by Jan de Maeseneer, on a petition to urge major donors to set aside 30% of their disease spend on integrated PHC and the Wonca/AfroPHC MOU with World Continuing Education Alliance by Craig Fitzpatrick to improve access to education that is African-based.
The rest of the workshop involved group discussion on the questions below:
What are the priority PHC workforce issues in Africa? It was felt that we need to address the policy context of low prioritisation of PHC and PHC workforce issues, including funding, decentralised PHC systems, human resource management, human resource development and e-health. It was felt that we needed appropriate models of PHC in Africa that included different cadres working to their own scopes but as a multidisciplinary team caring for a defined population, including addressing social determinants of health. PHC human resource management and development was non-standardised across Africa.
How should we address these priority PHC workforce issues? It was felt that AfroPHC needed to collaborate with a variety of stakeholders both to develop a clearer position and to advocate for PHC, the team and patient/community voices. This needed to translate across the various areas of importance: political will/funding/health systems, human resource management, human resource development and other important issues for PHC e.g. e-Health. There were many issues of importance to address in PHC human resource management and development.
What working groups should we be creating to take AfroPHC priorities forward? There were a few groups suggested: Policy, Training-Research, CHWs, Health Promotion and Teamwork (Interprofessional Collaborative Education and Practice).
The detailed group discussions will be captured in the AfroPHC Strategy for PHC in UHC.
In addition there were key statements regarding developing AfroPHC as an organisation that were gauged.
The African Forum for Primary Health Care (AfroPHC) came together in a three-day virtual workshop 4-7pm 9-11th September 2020, with 398 registrants from 28 African countries and ±100 participants per day. Each day involved an hour of moderated discussion between leaders of an illustrious list of organisations supporting AfroPHC, small breakout discussions involving participants and then feedback from groups and participants themselves. The workshop considered the following questions:
What does the community expect from ambulatory PHC service delivery in Africa?
Who should be part of the PHC team in African PHC Service?
How should the PHC team work in ambulatory PHC service delivery in Africa?
What support does the PHC team need in ambulatory PHC service delivery in Africa?
Participants felt report the workshop was outstanding for being highly interactive, informative, collaborative and productive. Next proposed steps include finalization of the statement, organizational development and clarification of specific objectives through additional workshops and expanding membership to include community voices.
“It was my first time to participate in such a brilliant platform” Joseph T. Kilasara
“The conference is one of its kind” Joyce Sibanda
The workshop emerged with the following statement:
“The African Forum for Primary Care (AfroPHC) consists of diverse multidisciplinary primary health care (PHC) workforce stakeholders from across Africa who share a vision for African PHC service delivery: It should be comprehensive, accessible, high quality, responsive to local needs, in partnership with communities and delivered by strong teamwork, training and supportive supervision.
Our key principles are:
NATURE OF PHC: African PHC service delivery should be personal, holistic, comprehensive, continuous, integrated, high-quality, well-resourced, accessible, affordable, socially acceptable and empowering. It should be provided by skilled inter-disciplinary and intersectoral team-based care with public-private partnerships and referral support.
PEOPLE-CENTRED PHC: African PHC service delivery should be responsive to the particular needs of communities in Africa and in partnership with them, linking and integrating facilities and communities.
PHC HUMAN RESOURCES: Whilst nurses, midwives, clinical officers, family doctors and community health workers are all core to integrated PHC service delivery in Africa we believe all healthcare professionals (including mental health, rehabilitation, oral health etc.) and other stakeholders (patients, administrative staff, community, traditional services, local leaders etc.) need to be part of the PHC team in an interprofessional team-based approach that balances curative with preventive care. Community healthcare workers should be treated and paid as professionals. Different models of PHC service delivery teams need to be explored across Africa based on and optimized with clear and defined human resource and population data, understanding of community needs and country resources.
PHC CAPACITY DEVELOPMENT: We believe that training of all healthcare professionals for PHC service delivery should be intensified and all professionals should be trained inter-professionally in different levels of comprehensive family and community care rather than just in narrow fragmented task-shifting. Health systems must ensure that all team members are well-trained in the principles of family medicine and PHC so as to deliver high quality bio-psycho-social-spiritual personal healthcare and be able to practice to a scope that is most efficient for each country.
PHC TEAMWORK: We expect coordinated, collaborative and consultative interprofessional teamwork between us as an integrated PHC service delivery team with all team members demonstrating and supporting each other in skills of leadership and accountability. This should be supported by mandated interprofessional education, especially in undergraduate, basic training and continuing professional development.
INCLUSIVE PHC LEADERSHIP: We will grow to be inclusive of all Anglophone, Francophone and Lusophone countries in Africa and provide good leadership as advocates – engaging politicians, community and PHC workers in a mix of collaboration, community engagement, training, research and guideline development.
PHC ADVOCACY: We, as AfroPHC, see our way forward as building an Africa-specific, inter-disciplinary and inter-sectoral collaborative network for advocacy of PHC and UHC. We will advocate for:
PHC teamwork to be prioritized with political and financial support and policies, education and training, infrastructure, community support, public-private partnerships, stronger supervision and teambuilding.
Sufficient financial commitment to PHC, including encouraging community health insurance schemes; good management and effective leadership including effective communication; availability of medicines, equipment, diagnostics etc.; effective referral and transport systems and use of information and communication technologies.
Availability of and incentives for a skilled and empowered PHC workforce to make a difference with the care needed in each community, especially in rural settings
Interprofessional training-education and basic qualifications as well as ongoing health education, including team functioning, knowledge and practices, to provide quality care and training.
Research and data collection as an integral part of PHC, including standardized human resource data
A “health in all policies” framework for health promotion in the community.
O Fórum Africano de Atenção Primária à Saúde (AfroPHC) reuniu-se em um workshop virtual de três dias das 16h às 19h, 9-11 de setembro de 2020, com 398 inscritos de 28 países africanos e ± 100 participantes por dia. Cada dia envolveu uma hora de discussão moderada entre os líderes de uma ilustre lista de organizações que apóiam o AfroPHC, pequenas discussões abertas envolvendo os participantes e então o feedback dos grupos e dos próprios participantes. O workshop considerou as seguintes questões: • O que a comunidade espera da prestação de serviços ambulatoriais de APS na África? • Quem deve fazer parte da equipe de APS no Serviço Africano de APS? • Como a equipe de APS deve trabalhar na prestação de serviços ambulatoriais de APS na África? • De que apoio a equipe de APS precisa para a prestação de serviços ambulatoriais de APS na África?
Os participantes sentiram que o relatório do workshop foi excelente por ser altamente interativo, informativo, colaborativo e produtivo. As próximas etapas propostas incluem a finalização da declaração, o desenvolvimento organizacional e o esclarecimento de objetivos específicos por meio de workshops adicionais e expansão do quadro de membros para incluir vozes da comunidade.
“Foi a primeira vez que participei de uma plataforma tão brilhante” Joseph T. Kilasara “A conferência é única em seu tipo” Joyce Sibanda
O workshop surgiu com a seguinte afirmação:
“O Fórum Africano de Atenção Primária (AfroPHC) consiste em diversas partes interessadas multidisciplinares de atenção primária à saúde (APS) de toda a África que compartilham uma visão para a prestação de serviços de APS africana: Deve ser abrangente, acessível, de alta qualidade, responsivo às necessidades locais, em parceria com as comunidades e proporcionado por um forte trabalho em equipe, treinamento e supervisão de apoio.
Nossos princípios-chave são:
NATUREZA DA APS: A prestação de serviços da APS africana deve ser pessoal, holística, abrangente, contínua, integrada, de alta qualidade, com bons recursos, acessível, acessível, socialmente aceitável e capacitadora. Deve ser fornecido por meio de cuidados qualificados, interdisciplinares e intersetoriais, com parcerias público-privadas e apoio de referência.
APS CENTRADA NA PESSOA: A prestação de serviços de APS africana deve responder às necessidades particulares das comunidades em África e em parceria com elas, ligando e integrando instalações e comunidades.
RECURSOS HUMANOS DE APS: Embora enfermeiras, parteiras, funcionários clínicos, médicos de família e trabalhadores comunitários de saúde sejam essenciais para a prestação de serviços de APS integrados na África, acreditamos que todos os profissionais de saúde (incluindo saúde mental, reabilitação, saúde bucal, etc.) e outras partes interessadas (pacientes, equipe administrativa, comunidade, serviços tradicionais, líderes locais, etc.) precisam fazer parte da equipe de APS em uma abordagem baseada em equipe interprofissional que equilibra cuidados curativos e preventivos. Os profissionais de saúde comunitários devem ser tratados e pagos como profissionais. Diferentes modelos de equipes de prestação de serviços de APS precisam ser explorados em toda a África com base e otimizados com recursos humanos e dados populacionais claros e definidos, compreensão das necessidades da comunidade e recursos do país.
DESENVOLVIMENTO DA CAPACIDADE DE APS: Acreditamos que o treinamento de todos os profissionais de saúde para a prestação de serviços de APS deve ser intensificado e todos os profissionais devem ser treinados interprofissionalmente em diferentes níveis de atenção integral à família e à comunidade, ao invés de apenas em trocas estreitas e fragmentadas de tarefas. Os sistemas de saúde devem garantir que todos os membros da equipe sejam bem treinados nos princípios da medicina de família e da APS, de modo a oferecer cuidados de saúde pessoais bio-psico-sociais-espirituais de alta qualidade e serem capazes de praticar a prática de forma mais eficiente para cada país .
TRABALHO EM EQUIPE DE APS: Esperamos um trabalho em equipe interprofissional coordenado, colaborativo e consultivo entre nós como uma equipe integrada de prestação de serviços de APS, com todos os membros da equipe demonstrando e apoiando uns aos outros em habilidades de liderança e responsabilidade. Isso deve ser apoiado por educação interprofissional obrigatória, especialmente na graduação, treinamento básico e desenvolvimento profissional contínuo.
LIDERANÇA DE APS INCLUSIVA: Cresceremos para incluir todos os países anglófonos, francófonos e lusófonos na África e oferecer uma boa liderança como defensores – envolvendo políticos, comunidade e trabalhadores de APS em uma mistura de colaboração, envolvimento da comunidade, treinamento, pesquisa e desenvolvimento de diretrizes.
DEFESA DE APS: Nós, como AfroPHC, vemos nosso caminho adiante como a construção de uma rede colaborativa interdisciplinar e intersetorial específica para a África para a defesa de CPS e cobertura universal de saúde. Vamos defender:
O trabalho em equipe da APS deve ser priorizado com apoio político e financeiro e políticas, educação e treinamento, infraestrutura, apoio comunitário, parcerias público-privadas, supervisão mais forte e formação de equipes.
Compromisso financeiro suficiente para a APS, incluindo o incentivo a esquemas de seguro saúde comunitário; boa gestão e liderança eficaz, incluindo comunicação eficaz; disponibilidade de medicamentos, equipamentos, diagnósticos etc .; sistemas eficazes de encaminhamento e transporte e uso de tecnologias de informação e comunicação.
Disponibilidade e incentivos para uma força de trabalho qualificada e capacitada na APS para fazer a diferença com os cuidados necessários em cada comunidade, especialmente em ambientes rurais
Formação interprofissional-educação e qualificações básicas, bem como educação permanente em saúde, incluindo o funcionamento da equipe, conhecimentos e práticas, para fornecer atendimento e treinamento de qualidade.
Pesquisa e coleta de dados como parte integrante da APS, incluindo dados padronizados de recursos humanos
Uma estrutura de “saúde em todas as políticas” para a promoção da saúde na comunidade.
Le Forum africain pour les soins de santé primaires (AfroPHC) s’est réuni dans un atelier virtuel de trois jours de 16h à 19h du 9 au 11 septembre 2020, avec 398 inscrits de 28 pays africains et ± 100 participants par jour. Chaque jour comportait une heure de discussion modérée entre les dirigeants d’une illustre liste d’organisations soutenant l’AfroPHC, de petites discussions en petits groupes impliquant les participants, puis les commentaires des groupes et des participants eux-mêmes. L’atelier a examiné les questions suivantes: • Qu’attend la communauté de la prestation de services ambulatoires de SSP en Afrique? • Qui devrait faire partie de l’équipe SSP dans le service SSP en Afrique? • Comment l’équipe SSP devrait-elle travailler dans la prestation de services ambulatoires de SSP en Afrique? • De quel soutien l’équipe SSP a-t-elle besoin pour la prestation de services ambulatoires de SSP en Afrique?
Les participants ont estimé que l’atelier était exceptionnel pour sa grande interactivité, ses informations, sa collaboration et sa productivité. Les prochaines étapes proposées comprennent la finalisation de la déclaration, le développement organisationnel et la clarification des objectifs spécifiques par le biais d’ateliers supplémentaires et l’élargissement du nombre de membres pour inclure les voix de la communauté.
«C’était la première fois que je participais à une plateforme aussi brillante» Joseph T. Kilasara «La conférence est unique en son genre» Joyce Sibanda
L’atelier a émergé avec la déclaration suivante:
«Le Forum africain pour les soins primaires (AfroPHC) est composé de divers acteurs multidisciplinaires du personnel des soins de santé primaires (SSP) de toute l’Afrique qui partagent une vision de la prestation de services de SSP en Afrique: il doit être complet, accessible, de haute qualité, sensible aux besoins locaux, en partenariat avec les communautés et assuré par un solide travail d’équipe, une formation et une supervision de soutien.
Nos principes clés sont:
NATURE DES SSP: La prestation de services de SSP en Afrique doit être personnelle, holistique, complète, continue, intégrée, de haute qualité, bien dotée en ressources, accessible, abordable, socialement acceptable et responsabilisante. Il doit être assuré par des soins en équipe interdisciplinaires et intersectoriels qualifiés avec des partenariats public-privé et un soutien à l’orientation.
SSP CENTRÉS SUR LES PERSONNES: La prestation de services de SSP en Afrique doit être adaptée aux besoins particuliers des communautés en Afrique et en partenariat avec elles, reliant et intégrant les installations et les communautés.
RESSOURCES HUMAINES DE SSP: Alors que les infirmières, les sages-femmes, les cliniciens, les médecins de famille et les agents de santé communautaires sont tous au cœur de la prestation intégrée de services de SSP en Afrique, nous croyons que tous les professionnels de la santé (y compris la santé mentale, la réadaptation, la santé bucco-dentaire, etc.) et d’autres parties prenantes (patients, personnel administratif, communauté, services traditionnels, dirigeants locaux, etc.) doivent faire partie de l’équipe de soins de santé primaires dans une approche d’équipe interprofessionnelle qui équilibre les soins curatifs et préventifs. Les agents de santé communautaires devraient être traités et payés comme des professionnels. Différents modèles d’équipes de prestation de services de SSP doivent être explorés à travers l’Afrique sur la base et optimisés avec des données claires et définies sur les ressources humaines et la population, la compréhension des besoins de la communauté et des ressources nationales.
DÉVELOPPEMENT DES CAPACITÉS DE SSP: Nous croyons que la formation de tous les professionnels de la santé pour la prestation de services de SSP devrait être intensifiée et que tous les professionnels devraient être formés de manière interprofessionnelle à différents niveaux de soins complets de la famille et de la communauté plutôt que simplement dans une répartition étroite et fragmentée des tâches. Les systèmes de santé doivent veiller à ce que tous les membres de l’équipe soient bien formés aux principes de la médecine familiale et des soins de santé primaires afin de fournir des soins de santé personnels bio-psycho-sociaux-spirituels de haute qualité et être en mesure de pratiquer dans le cadre le plus efficace pour chaque pays.
TRAVAIL D’ÉQUIPE DE SSP: Nous nous attendons à un travail d’équipe interprofessionnel coordonné, collaboratif et consultatif entre nous en tant qu’équipe intégrée de prestation de services de SSP, tous les membres de l’équipe démontrant et se soutenant mutuellement en matière de leadership et de responsabilité. Cela devrait être soutenu par une formation interprofessionnelle obligatoire, en particulier au premier cycle, la formation de base et le développement professionnel continu.
LEADERSHIP INCLUSIF DES SSP: Nous grandirons pour inclure tous les pays anglophones, francophones et lusophones d’Afrique et fournirons un bon leadership en tant que défenseurs – en engageant les politiciens, les communautés et les travailleurs des SSP dans un mélange de collaboration, d’engagement communautaire, de formation, de recherche et de lignes directrices développement.
PLAIDOYER SUR LES SSP: En tant qu’AfroPHC, nous voyons notre voie à suivre comme la construction d’un réseau de collaboration interdisciplinaire et intersectorielle spécifique à l’Afrique pour le plaidoyer pour les SSP et la CSU. Nous plaiderons pour:
une. Le travail d’équipe des SSP doit être priorisé avec un soutien politique et financier et des politiques, l’éducation et la formation, les infrastructures, le soutien communautaire, les partenariats public-privé, une supervision renforcée et le renforcement de l’esprit d’équipe.
Un engagement financier suffisant en faveur des SSP, notamment en encourageant les régimes d’assurance maladie communautaire; bonne gestion et leadership efficace, y compris une communication efficace; disponibilité des médicaments, équipements, diagnostics, etc .; systèmes efficaces d’orientation et de transport et utilisation des technologies de l’information et de la communication.
Disponibilité et incitation pour une main-d’œuvre de SSP qualifiée et habilitée à faire une différence avec les soins nécessaires dans chaque communauté, en particulier en milieu rural ré.
Formation-éducation interprofessionnelle et qualifications de base ainsi que l’éducation sanitaire continue, y compris le fonctionnement de l’équipe, les connaissances et les pratiques, pour fournir des soins et une formation de qualité.
Recherche et collecte de données en tant que partie intégrante des SSP, y compris des données normalisées sur les ressources humaines
Un cadre «la santé dans toutes les politiques» pour la promotion de la santé dans la communauté.
Two years ago, at the Global Conference on Primary Health Care (PHC) in Astana, world leaders committed to strengthening PHC as the cornerstone of resilient health systems as the most effective pathway toward health for all. Now, the COVID-19 pandemic has made acting on those commitments more urgent than ever.
On today’s second anniversary of the Declaration of Astana, we are thrilled to announce the launch of the Allies Improving PHC, 29 diverse organizations committed to advancing PHC on the road to health for all. This community is joining together across regions and issue areas to call for collective action on improving PHC as the most effective way to meet the majority of health needs in times of crisis and calm. If your organization is committed to PHC and interested in becoming an Ally, we hope you will reach out through this survey.
We are excited to kick off #StrongerwithPHC, a virtual campaign to amplify and remind the global community of the promise of Astana. To amplify this critical call for stronger PHC for all, we hope you will join in online using this social toolkit, which includes content to promote, graphics to share and handles to follow throughout this week (26-30 October).
We are also delighted to share a commentary in BMJ Opinion – co-authored by the PHCPI Steering Committee Members – which highlights the commitments made at Astana and the importance of redoubling our efforts to improve PHC as we continue to contend with COVID-19.
We must strengthen PHC as the cornerstone of effective, equitable health systems as countries recover from the pandemic and beyond. Today, let us be reminded that we are #StrongerwithPHC, and that together, we can make #HealthforAll a reality.
Beth Tritter Executive Director Primary Health Care Performance Initiative
The first session 4-7pm Central African time 9th September was moderated by Champion Nyoni. Participants were introduced to Mentimeter to provide feedback. There were over 100 participants from a number of countries in Africa (South Africa, Kenya, Nigeria, Uganda, Malawi, Sudan, South Sudan, Tanzania) as well as globally (USA, Belgium, Germany, Lebanon, Argentina and The Netherlands. Participants felt overwhelmingly excited about the workshop with some anxiety around internet, times, unsure what to expect and being the first of its kind.
Shabir Moosa, shared what and who AfroPHC was all about. Champion Nyoni talked on the Myers Briggs Type Indicator (MBTI). After the first hour the session broke into two rounds of different group discussions of 15 minutes each with introductions and reflecting on MBTI. Prosper Tumusiime of WHO AFRO welcomed the session between the group discussions. He mentioned several key global documents, including the Astana Declaration, the political declarations on UHC and SDG, and African declarations for financing. He bemoaned the lack of progress in Africa and called for acceleration of UHC especially for good acceptable quality PHC. Health systems were a priority, guided by the Regional Committee Framework for UHC/SDGs, documents strengthening the DHS and the UHC Flagship. He requested a whole society approach and welcomed efforts of AfroPHC in building teamwork.
The initial group feedback shared by participants was that this exciting meeting was very interactive with considerable value-added. Feedback on the MBTI was that it was an interesting opener and conversation starter. MBTI was seen as a very useful tool in teamwork. A closing remark was that the breakup sessions were just great despite nervousness around the technical challenges.
The second session 4-7pm Central African time 10th September with ±100 participants was moderated by Bongi Sibanda. Participants were introduced more explicitly to Mentimeter. Participants shared their professions: a mix of family doctors, nurses and other disciplines. Most participants were from Southern Africa with participants feeling excited and energised. The agenda was exploring what the community expects from ambulatory PHC service delivery in Africa. There was a well-moderated panel discussion for one hour, including several leaders within AfroPHC. There was then discussion in small groups of 8-12. After regrouping participants were excited, inspired and encouraged. The feedback from all participants on “What does the community expect from ambulatory PHC service delivery in Africa” was mostly accessible, comprehensive quality care in partnership with communities. Group feedback was that the community expects holistic accessible, acceptable multidisciplinary team care (including community healthcare workers), public-private partnerships and referrals that are tailored to the needs of the community and in partnership with them. The feedback from participants on the way forward was that it needed to be based on Africa-specific, multidisciplinary and multisectoral collaborative networking and advocacy. Participants found the session interactive, value-adding and innovative.
The third session 4-7pm Central African time 11th September with ±100 participants was moderated by Shabir Moosa. Participants were introduced more explicitly to Zoom Rooms and Mentimeter. Participants were from South Africa, Nigeria, Kenya, Tanzania, Malawi, Eswatini, Zimbabawe, USA, Germany and Argentina. Most were family physicians, family nurse practitioners, nurses, occupational therapists and a range of other professions. There was a quiz to get familiar with Mentimeter. People expected to interact more, meet primary care leaders from across Africa, learn about PHC in other countries, collaborate interprofessionally and across AfroPHC, and take action on a way forward to improve PHC in Africa. They enjoyed the panel discussions, interactions and group conversations.
Before the group discussions feedback was requested on “Who should be part of the PHC team in African PHC Service?” Nurses, doctors, pharmacists, community health care workers, dentist, social workers, occupational therapists’ clinical officers, and an array of others featured. There was a moderated panel discussion with leaders from AfroPHC and then discussion in small groups of 8-12 for 45 minutes on “Who should be part of the PHC team in African PHC Service?”, “How should the PHC teamwork in ambulatory PHC service delivery in Africa?” It was felt that all healthcare professionals and other stakeholders (patients, community and leaders) need to be part of the PHC team in an interprofessional team-based approach. There was tension between leadership by doctors and nurses, although a predominance expected coordinated, collaborative and consultative interprofessional teamwork. On “What support does the PHC team need in ambulatory PHC service delivery in Africa?” participants felt that PHC needed to be advocated for and prioritized with political and financial support and policies, education and training, infrastructure, community support, public-private partnerships, stronger supervision and teambuilding.
In closing participants felt that the workshop was outstanding for being highly interactive, informative, collaborative and networking. Suggestions for improvement were to have more networking workshops and include community voices.
On how we “Build PHC teamwork in Africa” participants suggested collaborations, regular workshops, training especially on teamwork, policy advocacy, and stakeholder engagement. On how we “Advocate for appropriate PHC and UHC” participants suggested good leadership, engaging politicians, community and PHC workers with a mix of research and training. Participants also wanted AfroPHC to be more formalized as an organization, with a conference/workshop statement emerging.
On the way forward most felt that AfroPHC should be formalized in an organizational format of a mix of individual membership with supporting organisations, with various activities suggested for AfroPHC to embark on, especially training, research, leadership and communication.
Primary healthcare is the backbone of all strong health systems and forms a critical part towards the achievement of Universal Health Coverage. Now more than ever before, primary care nurses particularly those working in rural and remote settings must be appropriately supported through robust education/clinical supervision to meet population health needs safely and effectively. I have been facilitating developments towards this work in Africa since 2014 both voluntarily and as part of my doctoral work. As part of my final Doctor of Nursing Practice Project, I am leading work on the development of an Afrocentric Family Nurse Practitioner to inform educational….more
We are well into the COVID-19 pandemic, and across Africa, there is a call to ease lockdown measures and restart the econo-my. However, it still falls to us as scientists, researchers, health care professionals, and leaders to keep up the message of physical distancing, use of masks and washing hands frequently.
Pandemics come without a rule book. We do not know how the disease will progress, as we are still understanding the virus, and effective therapies. In the interim however, we can continue to strengthen our work-force, and provide them with the tools to provide quality and effective care. AFREhealth has engaged in a series of ac-tivities to do just that. Webinars, publica-tions on websites and in scientific journals and even animations are being used. We can however, only build on this by having mem-bers share their experience and expertise. Write to us, either for the newsletter, or in the AFREhealth blog. Tel us what you need. Share with us your best practices. Share your frustrations and successes.
It is up to African researchers, scientists and healthcare workers, together with econo-mists and social scientists to define and re-spond to this challenge so that we can work for solutions for Africa ourselves and strengthen our systems for our people by understanding our local contexts.
This newsletter presents some of the COVID-19 work. It does present other activities as well. A reminder that though we are dealing with a pandemic, other activities and other diseases still still deserve our attention. Stay safe and healthy! …..