Emma Chademana-Munodawafa (PhD Candidate, Centre for Research in HIV/AIDS, School Of Public Health, University Of the Western Cape)
This year’s Public Health Association of South Africa (PHASA) conference was convened in Cape Town, 26-27 September 2013 and was a joint collaboration with the African Federation of Public Health Association (AFPHA). The conference kicked off with a full day Student Symposium where Public Health students presented and shared their work and had an opportunity to learn from experienced Public Health professionals.
The theme of the conference was ‘Africa’s Public Health Legacy: Beyond the MDGs’, looking at how far public health has come since the MDGs and the way forward after 2015. Discussions were centered on strategies and actions needed to move beyond the MDGs. The National Department of Health gave a presentation on South Africa’s implementation of the Health in All Policies (HiAP) approach to achieve health equity in the country. “HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts, in order to improve population health and health equity” WHO, 2012.
Specific discussions were on building new and strengthening existing leadership in the Health system, and strengthening the Health System. The necessity to enhance the capacity of young and emerging public health professionals was highlighted in presentations on teaching research skills to undergraduate medical students and on developing the next generation of health policy researchers.
The implementation of South Africa’s Primary Health Care (PHC) re-engineering strategy was a predominant feature throughout the conference. The re-engineering initiative was largely informed by Brazil’s hailed Health Sector Reform where health outcomes were improved by expanding the role of community workers in health teams. A question raised was whether South Africa can replicate Brazil’s success; participants thought South Africa’s PHC re-engineering can be successful if the under-lying causes of ill-health and health human resource shortages are addressed. Furthermore, community participation was highlighted as a vital component of the PHC reengineering strategy.
Other recommendations for the success of the PHC re-engineering strategy were increasing the number of CHWs in the country while at the same time widening their scope of practice, allowing them to provide more health care services. It was advocated that CHWs be able to treat specific diseases such as childhood pneumonia prescribing antibiotics as they can successfully perform these tasks as evidenced in other countries.
Community participation was further echoed in a presentation of the Operation Sukuma Sakhe initiative in South Africa’s KwaZulu-Natal Province. Operation Sukuma Sakhe- which translates as “Let us all stand up and build”- is a community partnership programme initiated by the KwaZulu-Natal department of Health whit the aim of addressing the social determinants of ill health in the province.
Overall, the main recommendations moving beyond 2015 were greater community involvement in healthcare provision, a re-organization of Community Health Workers tasks, intersectoral approaches in government with an appreciation of public health as an essential component of South Africa’s health system.