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AfroPHC Statement

28 November, 2020

Dear colleagues

Please see the AfroPHC Statement below. Also translated into French and Portuguese. See webpage here https://afrophc.org/2020/11/26/afrophc-statement/ Feel free to circulate.

Pray, keep well and safe

rgds, Shabir

Prof S. Moosa

The African Forum for Primary Health Care (AfroPHC) came together in a three-day virtual workshop 4-7pm 9-11th September 2020, with 398 registrants from 28 African countries and ±100 participants per day. Each day involved an hour of moderated discussion between leaders of an illustrious list of organisations supporting AfroPHC, small breakout discussions involving participants and then feedback from groups and participants themselves. The workshop considered the following questions:

What does the community expect from ambulatory PHC service delivery in Africa?

Who should be part of the PHC team in African PHC Service?

How should the PHC team work in ambulatory PHC service delivery in Africa?

What support does the PHC team need in ambulatory PHC service delivery in Africa?

Participants felt report the workshop was outstanding for being highly interactive, informative, collaborative and productive. Next proposed steps include finalization of the statement, organizational development and clarification of specific objectives through additional workshops and expanding membership to include community voices.

“It was my first time to participate in such a brilliant platform” Joseph T. Kilasara

“The conference is one of its kind” Joyce Sibanda

The workshop emerged with the following statement:

“The African Forum for Primary Care (AfroPHC) consists of diverse multidisciplinary primary health care (PHC) workforce stakeholders from across Africa who share a vision for African PHC service delivery: It should be comprehensive, accessible, high quality, responsive to local needs, in partnership with communities and delivered by strong teamwork, training and supportive supervision.

Our key principles are:

NATURE OF PHC: African PHC service delivery should be personal, holistic, comprehensive, continuous, integrated, high-quality, well-resourced, accessible, affordable, socially acceptable and empowering. It should be provided by skilled inter-disciplinary and intersectoral team-based care with public-private partnerships and referral support.

PEOPLE-CENTRED PHC: African PHC service delivery should be responsive to the particular needs of communities in Africa and in partnership with them, linking and integrating facilities and communities.

PHC HUMAN RESOURCES: Whilst nurses, midwives, clinical officers, family doctors and community health workers are all core to integrated PHC service delivery in Africa we believe all healthcare professionals (including mental health, rehabilitation, oral health etc.) and other stakeholders (patients, administrative staff, community, traditional services, local leaders etc.) need to be part of the PHC team in an interprofessional team-based approach that balances curative with preventive care. Community healthcare workers should be treated and paid as professionals. Different models of PHC service delivery teams need to be explored across Africa based on and optimized with clear and defined human resource and population data, understanding of community needs and country resources.

PHC CAPACITY DEVELOPMENT: We believe that training of all healthcare professionals for PHC service delivery should be intensified and all professionals should be trained inter-professionally in different levels of comprehensive family and community care rather than just in narrow fragmented task-shifting. Health systems must ensure that all team members are well-trained in the principles of family medicine and PHC so as to deliver high quality bio-psycho-social-spiritual personal healthcare and be able to practice to a scope that is most efficient for each country.

PHC TEAMWORK: We expect coordinated, collaborative and consultative interprofessional teamwork between us as an integrated PHC service delivery team with all team members demonstrating and supporting each other in skills of leadership and accountability. This should be supported by mandated interprofessional education, especially in undergraduate, basic training and continuing professional development.

INCLUSIVE PHC LEADERSHIP: We will grow to be inclusive of all Anglophone, Francophone and Lusophone countries in Africa and provide good leadership as advocates - engaging politicians, community and PHC workers in a mix of collaboration, community engagement, training, research and guideline development.

PHC ADVOCACY: We, as AfroPHC, see our way forward as building an Africa-specific, inter-disciplinary and inter-sectoral collaborative network for advocacy of PHC and UHC. We will advocate for:

- PHC teamwork to be prioritized with political and financial support and policies, education and training, infrastructure, community support, public-private partnerships, stronger supervision and teambuilding.

- Sufficient financial commitment to PHC, including encouraging community health insurance schemes; good management and effective leadership including effective communication; availability of medicines, equipment, diagnostics etc.; effective referral and transport systems and use of information and communication technologies.

- Availability of and incentives for a skilled and empowered PHC workforce to make a difference with the care needed in each community, especially in rural settings

- Interprofessional training-education and basic qualifications as well as ongoing health education, including team functioning, knowledge and practices, to provide quality care and training.

- Research and data collection as an integral part of PHC, including standardized human resource data

- A “health in all policies” framework for health promotion in the community.

[French and Portuguese versions at above URL]

HIFA profile: Shabir Moosa is an Associate Professor and Family Physician in the Department of Family Medicine & Primary Health Care, Johannesburg Health District and University of Witwatersrand. Visit website www.profmoosa.com and email shabir AT profmoosa.com