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PHC success relies on CHWs being able to do more

Written by Health-e News

CAPE TOWN – South Africa needs to urgently look to countries such as Rwanda, Thailand and Brazil, where they have employed community health workers (CHWs) to deliver a range of primary health care services that dramatically reduced mortality, public health expert Professor David Sanders told the National Health Assembly (NHA).

Speaking during yesterday’€™s (THURS) plenary session, Sanders said by extending the scope of what CHWs could do and by supporting properly selected and trained individuals, the country could make a very real impact on maternal and child mortality.

For many years the head of the School of Public Health at the University of the Western Cape, Sanders is an iconic figure in the field of public health internationally.

His work has contributed hugely to the understanding of primary health care as a framework for health and development, and to improvements in child health through research, teaching and training, and policy advocacy and service development.

The appointment of part-time CHWs could create between 400 and 500 000 jobs, Sanders said.

He added that it was critical that these workers would among others be allowed to do HIV tests, pregnancy tests, Vitamin A supplementation, the distribution of family planning, oral rehydration therapy and zinc for diarrhoea, deworming, malaria treatment and prescribe antibiotics for pneumonia, one of the biggest killers of children.

The current proposed workload for CHWs was impossible and would lead to the re-engineering of South Africa’€™s primary health care system failing, Sander warned.

Sanders accused nurses and doctors of being the main forces opposing the extension of the scope of practice of these CHWs.

‘€œWe need to reduce the power of conservative heath professional bodies such as the Health Professions Council and the Nursing Council or we will be in the same place in 10 years time,’€ he added.

‘€œIf we get the unions to agree and we appoint these part-time CHWs, we could get the coverage attained in places like Thailand and Rwanda,’€ said Sanders.

Sanders said it was also critical for South Africa to stand up to the industries dominating the unhealthy food environment and in essence driving the obesity epidemic.

He said local such as Tiger Brands and internationals such as Nestle and Parmalat dominated with supermarkets supply up to 60% of food to households.

‘€œAnd our government says Walmart is welcome,’€ he said.

A survey conducted by Sanders and fellow researchers revealed that between 2005 and 2010 the consumption of ready made meals went up by 43 percent in South Africa and that of unhealthy snacks bars, also by 43 percent.

Sanders pointed out that South Africa had the lowest rate of exclusive breastfeeding in the world (8% of infants under 6 months) with government allowing infant formula feed companies to ‘€œget right inside our health system’€.

Health and social justice activists as well as health ministers and key policy makers from across the world are meeting in Cape Town this week to address the drivers of inequity which fundamentally impact on the health of the poor.

The NHA, which focuses on South Africa, ends today (FRI) after which health minister Dr Aaron Motsoaledi will open the international People’€™s Health Assembly this afternoon (FRI).

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Health-e News

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