A community-based healthcare programme is transforming the lives of thousands of people in mining communities across the country by taking healthcare directly into their homes – and it could offer the country an integrated approach to primary healthcare.
The community-oriented primary care (COPC) programme is a joint project between Anglo American, the Impact Catalyst (which is made up of Anglo American and a group of partners), the University of Pretoria; and the Department of Health.
The programme has been running in the communities in Richtersveld, in the Free State and around Anglo American’s Mogalakwena mine in Limpopo since 2019. It supports community health workers to provide quality, integrated primary healthcare services, chronic medication and improve client health literacy directly to people in their homes and coordinate care throughout their healthcare journey.
Dr Suzi Malan, from the University of Pretoria’s Department of Family Medicine, which implements the COPC programme, says the programme has made a significant change in the level of healthcare provided to mineworkers and community members. It had reduced the need for people to travel to and from formal healthcare facilities, and strengthened the capacity of existing community healthcare workers.
“We estimate that upwards of 84% of all South Africans don’t have private medical aids, so they rely on overstretched clinics and hospitals for primary healthcare. This approach takes healthcare away from the facilities and back to the household. It’s a massive paradigm shift – and our experience suggests that if this COPC system was functional across the country, it would have significantly eased the impact of Covid-19 on the healthcare system,” said Dr Malan.
More than 100 clinical associates have been visiting people in their homes in Richtersveld and Mogalakwena to conduct Covid-19 testing, undertake clinical assessments of patients, and provide food parcels comprising essential consumables where necessary.
The programme has over 92 000 registered individuals so far, of which 40% are under the age of 19. Through screening and testing for general health issues such as diabetes, HIV, hypertension and TB, it has identified around 19 200 chronic medication users. Between May 2021 and March 2022, the programme conducted around 217 household assessments, with clinical care and support provided to 149 and 25 patients referred to doctors.
The programme also delivered community support for sexual and gender-based violence, mental health concerns and substance abuse to 86 households in the Richtersveld and Mogalakwena communities, with 48 patients referred to home-based care, community organisations, local clinics or social services.
Sister Sylvia Diase, Local Area Manager for Mapela in Mogalakwena municipality, said the partnership with the mine and the UP clinical associates had a major impact on the community’s ability to manage the pandemic.“They enabled us to follow up on close contacts and help families, and we managed the Covid-19 surges so well because we were working together,” she said.
“Our focus with this project is to uplift communities by understanding their healthcare needs and to enable people to deal with their health issues at an earlier stage. The programme works to strengthen existing community health worker networks, who are a vital cadre of healthcare workers, and to enable the quality improvement of a system to fulfil its potential,” said Dr Alexandra Plowright, Group Community Health and Wellbeing Lead at Anglo American.
