Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa

Cape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, th...

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Main Authors: Robert Mash, Charlyn Goliath, Gio Perez
Format: Article
Language:English
Published: AOSIS 2020-11-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
Online Access:https://phcfm.org/index.php/phcfm/article/view/2607
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author Robert Mash
Charlyn Goliath
Gio Perez
author_facet Robert Mash
Charlyn Goliath
Gio Perez
author_sort Robert Mash
collection DOAJ
description Cape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19. Facilities were re-organised to have ‘screening and streaming’ at the entrance and patients were separated into hot and cold streams. Both streams had ‘see and treat’ stations for the rapid treatment of minor ailments. Patients in separate streams were then managed further. If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers. Community health workers also engaged in community-based screening and testing. Initial evaluation of PHC preparedness was generally good. However, a number of key issues were identified. Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter. Managers had to actively address the anxiety and fears of the primary care workforce. Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased. The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed. Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time.
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spelling doaj.art-6ff79046f07344f1af3d8832e1b434dd2022-12-21T23:39:21ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362020-11-01121e1e410.4102/phcfm.v12i1.2607788Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South AfricaRobert Mash0Charlyn Goliath1Gio Perez2Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape TownMetropolitan Health Services, Western Cape Department of Health, Cape TownMetropolitan Health Services, Western Cape Department of Health, Cape TownCape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19. Facilities were re-organised to have ‘screening and streaming’ at the entrance and patients were separated into hot and cold streams. Both streams had ‘see and treat’ stations for the rapid treatment of minor ailments. Patients in separate streams were then managed further. If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers. Community health workers also engaged in community-based screening and testing. Initial evaluation of PHC preparedness was generally good. However, a number of key issues were identified. Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter. Managers had to actively address the anxiety and fears of the primary care workforce. Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased. The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed. Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time.https://phcfm.org/index.php/phcfm/article/view/2607primary health careservice deliverycovid-19corona virussars-cov-2
spellingShingle Robert Mash
Charlyn Goliath
Gio Perez
Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
African Journal of Primary Health Care & Family Medicine
primary health care
service delivery
covid-19
corona virus
sars-cov-2
title Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
title_full Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
title_fullStr Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
title_full_unstemmed Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
title_short Re-organising primary health care to respond to the Coronavirus epidemic in Cape Town, South Africa
title_sort re organising primary health care to respond to the coronavirus epidemic in cape town south africa
topic primary health care
service delivery
covid-19
corona virus
sars-cov-2
url https://phcfm.org/index.php/phcfm/article/view/2607
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AT charlyngoliath reorganisingprimaryhealthcaretorespondtothecoronavirusepidemicincapetownsouthafrica
AT gioperez reorganisingprimaryhealthcaretorespondtothecoronavirusepidemicincapetownsouthafrica