Access literature on COPC
The following documents are useful to understand the NHI and PHC Re-engineering:
- ANC Health Plan 1994
- ANC NHI Proposal June 2009
- National Health Insurance in South Africa 2011
- PHC 3 Streams Overview 4 September 2011
- SA NDOH CCW Policy Framework 2009 with Code of Conduct
- Health Sector NSDA
The following forms are required by Community Health Workers (CHWs) in the PHC Outreach Team:
- HH registration form
- Referral/Back referral Form
- Individual Adult health record
- Maternal & Child health record
- CHW HH visit tick sheet
- CHW HH visit monthly summary
- OT monthly summary form
The CHWs keep the blank forms in a flip file and collect filled forms into a lever arch file using the following contents page – CHW File Cover – and key tools to make sense of the data collected on Household Registration Forms: Street Summary Sheets and CHW Family Profiles
The following forms are required for set up by the Team Leaders (TLs):
- TL CHW summary information sheet
- TL CHW Supervision Summary
- TL_Program Management Tools
- TL Monthly Summary sheet
- TL Program logistics and supplies checklist
The following forms are required for monthly evaluation of CHWs by TLs:
- TL_Guidance for evaluating CHW management of cases in the community
- TL_Evaluation of CHW Management of Sick Child in Community
- TL_Evaluation of CHW Antenatal home assessment
- TL_Evaluation of CHW post-natal home assessment
- TL_Post Assessment Discussion Questions
The Chiawelo Community Practice reports monthly using the tool: Chiawelo Monthly Report Form.
The Household Registration form (as well as Individual/Maternal forms) gets placed in a CHW file per family once captured on the CHW Family Profiles. A blank page is added for notes. The CHWs file has a cover page (Chiawelo CP Folder Family) and a genogram inside (Chiawelo CP Folder Genogram).
The CHWs file is kept together with the Community Practice records: a Family Folder ((Chiawelo CP Folder Family) a Patient Folder for all members of the member (Chiawelo CP Folder Patient) with a Problem List on the inside cover of each Patient Folder (Chiawelo CP Folder Problem List). All Household Registration respondents and patients visiting the Community Practice sign a Consent Form (Gauteng FM Consent Form). Clinicians occasionally use the International Classification of Primary Care 2-pager (ICPC Code Sheet) to collect data using the ICPC 2 Data_Collection_Sheet in addition to collecting DHIS data. Each clinician is given instructions for clinicians to the clinical workings of CCP.
We are also working hard to improve Ongoing Care. We have a record kept by clinicians CCP Ongoing Care Record 17-05-24, supplemented by a record of functionality CCP Review of functioning and ability. We also encourage clinicians to engage in strong teamwork with CHWs by providing notes in the CHW folder especially on psychosocial / education challenges that are then handed to CHWs. As we manage the patient we decide if the patient is stable and plan investigations / followup using the Ongoing Care Records, often 6-12 monthly. CHWs are expected to visit chronic patients three-monthly, especially to address medication adherence. We have also introduced a strong individual prevention programme using the CCP Preventive Care Record 18-06-08. It is premised on high-level evidence from the US Preventive Services Taskforce.
Patients are overjoyed!
There are a host of Wits students already going through Chiawelo Community Practice and benefiting from this experience:
- Medical Students
- Clinical Associate Students
- 2nd Year – 3-6 x 6-7 weekly x twice yearly
- Occupational Therapy Students
- 4th year
- Speech/Audiology Students
- 4th Year: 8 students x 6-7 weekly annually
- Sociology students – 1 visit per year
Join the CCP Clinician WhatsApp group when you join us.