Chiawelo Community Practice is an experiment in developing community-oriented primary care (COPC) more strongly in South Africa, as a model for GP-led teams contracted to the National Health Insurance (NHI). It is part of the Chiawelo Community Health Centre in Soweto, a facility owned by the public health service in South Africa. It also functions as part of the Wits University teaching and research platform. It is led by a family physician (Prof. Shabir Moosa). The team includes a family physician, an occasionally rotating 1st-year family medicine registrar, one clinical associate, three medical interns rotating weekly, one professional nurse, three enrolled nurses (team leaders), and 30-42 CHWs. They are caring for 30 000+ residents from the community of Ward 11, 12, 15, 16, & 19 in strong teamwork. Local stakeholders are engaged strongly, supporting a growing targeted health promotion programme. This has resulted in low utilisation rates (less than one visit per person per year), easy access aligned to need, high 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 were 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.
The International Institute for Primary Health Care-Ethiopia, in collaboration with Johns Hopkins Bloomberg School of Public Health is hosting a webinar on ‘Implementation research for PHC’ as the next installment in our series on Strengthening PHC Systems in LMICs. Professor Getnet Mitike of IPHC-E will moderate this session, with speakers joining us from The Johns Hopkins Bloomberg School of Public Health, USA and Pathfinder International…more