Collective Impact in South Africa
Posted by Community Manager 2 on November 4, 2022, 4:05 PM EDT
Advances and Capacity Building in Palliative and Cancer Care in Soweto
A collaboration of organizations lead clinically by Chris Hani Baragwanath Hospital (the "Bara") and Stanford's Center for Innovation in Global Health (CIGH), and lead technologically by Open Health Innovations, is exploring new interventions in palliative and cancer care in Soweto, a township of Johannesburg. Informed by diverse stakeholders including policymakers, the long term goal is to support implementation across all of South Africa.
Soweto is one of the iconic townships in South Africa with population estimates generally ranging from 2-5 million -- more precise numbers being unavailable due to the considerable number of undocumented residents. While the standard of living in Soweto is low and unemployment hovers in excess of 30% -- and considerably higher for its youth -- its economy is growing significantly.
Central and critical to this collaboration is that Soweto boasts the famous and enormous Bara and its 19 satellite clinics. The Bara, the largest hospital in Africa and one of the largest in the southern hemisphere, has an annual impact including:
- 150,000 ward patients
- 35,000 babies delivered
- 11,700 staff, professional and other
- 1,500 newly trained nurses
In general, the new program interventions encompass patient-families and lower level, community healthcare workers (CHWs) engaging and with greater information, effectiveness and regularity through mobile and web tools. These front line patient-caregiver and CHW "teams" are then further supported by advanced degree clinicians when necessary through remote, realtime video-conferencing.
The Bara and the Soweto Comprehensive Cancer Center mitigate through systematic monitoring and facilitating home management when appropriate, and triage to higher levels of care when it’s not. CHWs are identified from cancer survivors and caregivers because of their knowledge of cancer patients’ and families’ needs. Periodic monitoring fosters earlier intervention and targeting urgent situations for further care. Computational methods will be explored to incorporate “intelligent care” by identifying changes in self-reported health status that, in clinicians’ judgement, require in home assessment or urgent care.
The technology platform brought up to support the new clinical and social service interventions envisioned by the clinical team is SowetoHealth.Africa (SH.A), built and maintained by Open Health Innovations. SH.A has integrated mobile and web interfaces and encompasses a broad range of collaborative and clinical features including a patient-family controlled EHR, document management, instant messaging and integrated video-conferencing for remote patient care. SH.A will be run initially under security and privacy standards consistent with those found in HIPAA and then others that might be prescribed by South African regulators.