HSRC Integrated Annual Report 2018/2019

PHHSI Profile The programme seeks to use social, economic, behavioural and human sciences to generate evidence for health policy, health systems, and health promotion, and to enhance population health impact. The key research pillars are Health Economics and Health Systems; Health Promotion; Disease Prevention and Behavioural Sciences; Nutrition and Food Security; and Social and Behavioural Epidemiology. Research Highlights HealthRise Intervention The HealthRise Intervention aimed at understanding how to improve detection, management and control of cardiovascular disease and diabetes. The project, which was implemented in two districts of South Africa, demonstrated how trained community health workers (CHWs) can contribute to health systems strengthening and filling critical gaps in the detection, diagnosis and management of non-communicable diseases (NCDs). CHWs were trained in NCDs, risk factors, health education, howto screen for diabetes and hypertension, referral to a health care facility for confirmatory diagnosis, and following up on patients, in alignment with existing National Department of Health guidelines and infrastructure. The CHWs screened over 15 000 people during household visits, in public health clinics and during health education campaigns, both in the community and in work places. Over 30%had raised blood pressure and 6% screened positive for high blood glucose (>=11.0 mmol/L), and were referred to a clinic. Importantly, over a third of the referrals were newly detected cases of raised blood pressure and raised blood sugar; that is, they were previously unaware that they had these risk factors. The CHWs linked patients to care and those with confirmed diagnoses were initiated into treatment, andmonitored by CHWs via home visits. This process facilitated appropriate treatment adjustment, improved treatment adherence and patient empowerment for better management of their conditions. The household visits enabled CHWs to screen and monitor patients who would otherwise not have travelled to a clinic to access health care. The project also used a clinical mentor systemwhere diabetic nurses trained and mentored facility nurses on diabetes and chronic diseases management, offering one-on-one interactions, journal meetings and advice on treatment andmanagement of patients with complications. HealthRise demonstrated howCHWs, recruited from within the communities they serve, can contribute significantly toward detection and linkage to care, while working together with clinical staff within the National PART B: PERFORMANCE OVERVIEW POPULATION HEALTH, HEALTH SYSTEMS AND INNOVATION (PHHSI) Figure 17: Key Research Pillars of PHHSI Health Economics and Health Systems Health Promotion Disease Prevention and Behavioural Sciences Nutrition and Food Security Social and Behavioural Epidemiology 40 / HSRC INTEGRATED ANNUAL REPORT 2018/19