Integrating NCDs into existing structures at the Primary Care Level through training Community Based Health Workers in South Africa

Health care worker shortages and health budget constraints are well documented in Africa. With the rapid transition from infectious to non communicable diseases (NCDs) in South Africa, particularly in urbanising areas, the government must deal with NCDs on top of their existing case load of HIV and TB patients. This places tremendous strain on all levels of the health system resulting contributing to low detection rates of NCDs and a lack of awareness in communities about the unhealthy lifestyle risk factors for NCDs. The case load for professional health workers at the primary care level is too great, leading to many patients falling through the gaps due to large waiting lines, poor service provision and almost no patient education.

New approaches to detect and manage NCDs at the primary care level are needed. Lay workers, known as Community Health Workers (CHWs) can be strategically engaged to support professional health workers in case detection and patient education.

Project HOPE, in partnership with local government and community stakeholders is piloting “The HOPE Centre”, an innovative program using CHWs to provide community-wide information about healthy lifestyles and identify at risk candidates for further screening. Peer educators will provide comprehensive peer to peer support for patients who have NCDs such as diabetes.

Our presentation will discuss the South Africa program and strategies used to integrate NCD services into existing government structures.