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No queues, no fuss, bringing healthcare to your door

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For those living in ward 11, one of the poorer areas of Soweto, waiting in long queues for medical treatment had become increasingly problematic.

One of the first in Africa

For the inhabitants of this area, though, things have changed for the better. Nowadays, community-based health workers, trained and equipped with basic health education, go from door-to-door to do household assessments, gathering information about the family’s medical history. 

Chiawelo Community Practice (CCP) is an experiment in developing community-based care in South Africa, a model that involves General Practitioner (GP) teams contracted to the National Health Insurance. It is one of the first of these projects on the African continent.

CCP is led by Wits University’s family physician, Dr Shabir Moosa, with the help of his team of rotating first-year medical students, nurses and community health workers (CHWs), deployed from the community.

Wits' activities in Soweto communities are based on screening, educating and supporting health and intersectoral action.

Since March 2014, CCP has helped empower 25% of the inhabitants of Soweto by developing "community practice" and spans over nine wards around the are of Chiawelo.

chiawelo community

Image: CHW Coordinators during their weekly meeting, discussing challenges and health promotion across Chiawelo Community Practice in the wards. (Supplied)

Dr Moosa, former head of family physicians at the Johannesburg district hospital, told Health24 that each family in the nine wards gets a visit, where they do a household assessment.

A strong record-keeping system

The family is then given a letter, stating that a team at the CCP will provide all registered families' free health care services on a daily basis. 

Dr Moosa emphasises how important it is to have a health profile of every resident, and keeping track of their medical history so that they can have best possible engagement experience. 

"Having a strong record-keeping system at the clinic helps the patient-care crew. Viewing records from the community and engagement with the community helps them to do more focused health promotions that are relevant to the community,” said Moosa. 

chiawelo community practice

Image: CHW took health promotion to the streets testing for HIV, BP, diabetes and other diseases in Ramaphosa Park. (Supplied)

Dr Moosa explains that even though he got the go-ahead from his manager in 2013, he was faced with many management problems during the implementation process.

Comprehensive clinical services

"Managers were uptight, but because of the successful implementation of the programme, the community turned around and said, ‘No, we won’t let this close down.'"

In its first year of introduction, the CCP screened over 15 934 people in the township of Chiawelo, Soweto. 4 047 had problems, as reported by forgood website. CHW has since followed up on 85% of those problems, of which 79% have been solved.

CCP provides comprehensive clinical services, from immunisations to ARVs. This happens on an appointment basis with short waiting times, and includes high quality care and regular home visits by clinicians.

WATCH: An introduction into the Chiawelo Community Practice

 

You can find out more about the Chiawelo Community Practice and how you can help here.

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