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, two medical interns rotating weekly, one professional nurse, three enrolled nurses (team leaders), and 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.
Twenty CHWs are allocated over the geographic area of Ward 11 (Soweto part), the ward in which Chiawelo CHC is located, and caring for ±18 000 people (the bulk of patients registered at CCP). Chiawelo Community Practice is in the previous Child Health Section of the CHC (below).
The Chiawelo Community Practice (CCP) is modeled on moving from a curative to a preventive and promotive focus in health services, with the following drivers in a systems-based approach:
- Population engagement, with community health workers, as active parts of the team, building a profile of the community and strengthening daily interaction with the community.
- Practice re-organization with teamwork around person, family, and community, especially with an appointment system, strong problem-oriented medical records, and innovative communication.
- Structured collaboration with stakeholders in the health system, other government sectors/institutions, and with the community.
- Health promotion that accounts for the complexity of changing behaviour
It is being modeled for the context of National Health Insurance (especially considering private general practitioners working in teams). Have a look at key resources for setting up a Community Practice. See the video below. You can see slides for an updated view AfroCP Workshop 2014-10-10. See the Chiawelo CP Report as well as Progress Reports on CCP. Better still – VISIT us!
The objective is to build Chiawelo Community Practice as a centre of excellence. Our partnerships, innovations (including use of information technology – mobile data collection tool), and academic freedom are allowing us to engage socially and to contribute to important research and training (with undergraduates and postgraduates already moving through CCP). It has been used by the South African National Treasury in the feasibility testing of private general practitioners contracting for capitation under NHI. See proposal here. It is already achieving international visibility as the first African member of the International Federation of CHCs. We believe that the Chiawelo Community Practice will grow in influence.