Delivering on universal primary care in low and middle-income countries - using the Practical Approach to Care Kit
The Centre for Implementation Science invites you to a seminar with Associate Professor Lara Fairall, a South African doctor, implementation scientist and founding head of the Knowledge Translation Unit (KTU) at the University of Cape Town Lung Institute.
Primary health care is widely accepted as central to achieving the UN’s health-related sustainable development goals and the broader goal of ‘health for all’ by providing accessible, affordable and effective health care. Yet in many low- and middle-income countries primary health care is constrained by a lack of adequately skilled and supported health workers.
The KTU has spent 17 years developing, trialing and refining the Practical Approach to Care Kit (PACK) programme to train, support and empower nurses, mid-level health workers, doctors and community health workers in primary care.
In this seminar Professor Fairall will give an overview of the PACK approach, the evidence in which it is grounded, key learnings gained through 17 years of experience and position in knowledge translation frameworks and emergent learning health systems.
PACK comprises a clinical management guide for clinicians, a training programme based on educational outreach, a health systems clinical services strengthening component, and monitoring and evaluation. The concise but comprehensive guide addresses the 57 most common symptoms and 26 chronic conditions, and integrates content on communicable diseases, non-communicable diseases, mental disorders and women’s health. The educational outreach is on-site, case-based, completed in short sessions (1.5 hours) over several months and emphasises teamwork and task-sharing.
PACK has been adopted throughout South Africa’s 3,500 primary care clinics servicing 80 per cent of the population. Pilots have been completed in southern Malawi, Botswana, The Gambia, Mexico City and North Western Brazil. PACK is now available globally through a partnership between the KTU and the British Medical Journal, facilitating annual revision of the clinical content, and mentorship of in-country teams to localise and implement the programme in their settings. Work is currently underway in Brazil, Nigeria and Ethiopia and discussions ongoing in a further 10+ countries.
