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We are currently facing a primary healthcare crisis in Nigeria and speedy intervention is needed to salvage and enhance access to health care for our ever growing population.
Community health workers have the potential to enhance primary care access and quality, but remain underutilised in Nigeria.
A WHO report by Uta Lehmann and David Sanders from the School of Public Health University of the Western Cape, says;
‘The use of community health workers has been identified as one strategy to address the growing shortage of health workers, particularly in low-income countries. Using community members to render certain basic health services to the communities they come from is a concept that has been around for at least 50 years. There have been innumerable experiences throughout the world with programmes ranging from largescale, national programmes to small-scale, community-based initiatives’ (Evidence and Information for Policy, Department of Human Resources for Health Geneva, January 2007)
It is common knowledge that we do not have trained physician associates or assistants in primary care facilities to support medical doctors in providing primary care services; rather what we have in some communities are quacks, people parading themselves as medical doctors with no medical qualification what so ever.
But I don’t see any reason why we should not welcome the idea of training physician associates or assistants to fill in the gap for medical staff shortage, when other developing and developed countries that have better healthcare systems do have them.
In Nigeria we do not have enough doctors per population or geographical area, This is the time to train up more community health care workers as this would help in the much needed awareness creation and community based interventions for managing long term conditions, reducing childhood illnesses due to lack of immunisation. Trained birth attendants will also help reduce maternal mortality and community nursing care will reduce infant mortality.
In a typical medical centre in the UK for instance, healthcare assistants, advanced nurse practitioners, health trainers, clinical pharmacists or prescribers, work alongside doctors to provide patient centered care. This helps to reduce the work load on the doctors as these other clinicians and allied health workers have enough training and experience to manage long term conditions and participate in triage system.
In the UK, a lot of research has been done and there are calls to increase the health work force in the National Health Service (NHS) through the utilisation of community-based lay workers.
Below is an extract from a research published in the journal of Royal society of medicine curated by Dawn O’Shea:
‘’Introducing a workforce of community-based lay health workers in the NHS could address current general practitioners (GP) workload demands, while improving clinical outcomes, according to research published in the Journal of the Royal Society of Medicine.
In the 1960s, programmes in the US funded members of the community provide a bridge between patients and health care providers. By facilitating appointment-keeping and increasing medication compliance, community health workers improved access to and quality of health care, while reducing costs.
In Brazil, community health workers receive basic training in disease identification and monitoring, immunisation, screening and health promotion. They support patients with medication adherence and chronic disease monitoring and liaise proactively with GPs and practice nurses…..
The authors conclude that systematic integration of community health workers at scale in the NHS could be an effective and a rapidly implementable approach to the current primary care workload crisis’’.
(Hayhoe B & al. | J R Soc Med | 4 Oct 2018 from Dawn O’Shea | UK Medical News | 8 Oct 2018)
Another important area where the community healthcare workforce could be utilised effectively is emergency care or first aid. In most public and private places in Nigeria, there are no ambulance or paramedic services; having well trained community first aid responders would go a long way to save lives in times of emergency for example; cardiac arrest, collapse, and respiratory distress. Having a health unit manned by well-trained first aid responders in all public places like markets, motor parks etc is highly essential.
Healthcare provision anywhere in the world is capital intensive but we can start from the basics; we can reduce the burden or costs in secondary healthcare provision especially in our public hospitals if we lay more emphasis on patient health education and encourage people to engage in healthy living and self-care. Integrated healthcare practice at all levels is an efficient way of providing patient centered care where every member of the healthcare team contributes their quota.
Community healthcare workers are well placed to offer advice on healthy living and self-care in the language people of a specific demographic area would understand.
Hypertension, Chronic Kidney Disease, Type 2 diabetes mellitus, malaria, HIV/AIDs are among the diseases that could be prevented or well managed through patient education and lifestyle advise.
The role of health education cannot be overemphasized. For instance, there is still some form of stigma around epilepsy in some areas in the country; where people who are epileptic are believed to be possessed by some sort of evil spirits, in an unfortunate event of epileptic fits in public places, patients are not well cared for and objects like spoon etc. are inserted into their mouths in the believe that it keeps the airways open, this could be a choking hazard and has made recovery time worse for some patient. Community healthcare workers could perfectly fill that gap of providing basic health education and public health enlightenment.
In conclusion, addressing the primary healthcare crises in Nigeria is no mean feat, but we need to look at the issue holistically, it involves a multifaceted, public and private partnership, but the Government has to lead on this through the inaction of relevant laws and provision of training programmes, monitoring and evaluation etc.
Without health, life is not life; it is only a state of languor and suffering.
Clinical Pharmacist/UN SDG Advocate
Airbus and Koniku launch a disruptive biotechnology solutions for aviation security operations
Koniku Inc.-Airbus Aircraft cabin (credit: Airbus)
Toulouse – Airbus and Koniku Inc. have made a significant step forward in the co-development of a solution for aircraft and airport security operations by extending research activities to include biological hazard detection capabilities, as well as chemical and explosive threats.
The disruptive biotechnology solution, which was originally focused on the contactless and automated detection, tracking and location of chemicals and explosives on-board aircraft and in airports, is now being adapted in light of the COVID-19 crisis to include the identification of biological hazards.
Based on the power of odor detection and quantification found in nature, the technical solution, developed to meet the rigorous operational regulatory requirements of aircraft and airport security operations, uses genetically engineered odorant receptors that produce an alarm signal when they come into contact with the molecular compounds of the hazard or threat that they have been programmed to detect.
Airbus and Koniku Inc. entered into a cooperation agreement in 2017, leveraging Airbus’ expertise in sensor integration and knowledge of ground and on-board security operations within the aviation and defense industries, as well as Koniku’s biotechnology know-how for automated and scalable volatile organic compound detection (via their Konikore™ platform).
With in-situ testing planned for Q4 2020, Airbus is demonstrating its ability to accelerate traditional research cycles in a real-time environment in order to develop and bring to market a game-changing, end-to-end, security solution at convincing scale and speed, thereby contributing to the continuous improvement of security in the air transport ecosystem, while increasing operational efficiency and improving passenger experience.
Low risk of COVID-19 in SA water systems
There is no evidence that COVID-19 will contaminate water supplies, but the pandemic has highlighted water challenges putting communities’ health at risk, say industry stakeholders.
Panelists participating in a high-level webinar hosted by Messe Muenchen South Africa, organiser of IFAT Africa, said last week that although international scientists were using COVID-19 RNA in sewage to track the prevalence of the virus in communities, there was no evidence that COVID-19 could pose a risk via drinking water. However, the pandemic was highlighting the health risks up to 30% of the South African population faces through lack of access to piped water.
The virus does not survive waste-water treatment plant processing or the treatment for reuse, the panellists said.
Hennie Pretorius, Industry Manager Water and Waste Water at Endress + Hauser, said: “There have been concerns that this virus could enter the water supply, but the good news is that with proper disinfection of waste water, we should not see the viruses entering rivers, and proper filtration should eliminate any risk in the drinking water supply.”
“There is no evidence of COVID-19 entering water supply systems at this stage, but even if it did, the technology exists to remove such viruses,” said Henk Smit, MD of Vovani Water Products.
Panellists said the pandemic had highlighted the health risks facing those South Africans who do not have access to treated, piped water, however. Taking tanks of water to underserved areas raised water quality concerns, while shared taps increased communities’ risk of contracting the virus, they noted.
Achim Wurster, Chairman of the Water Institute of South Africa (WISA) said: “There could be some risks in the standpipes in poorer communities, where people congregate and touch the tap – and this is where education comes in. But we are not aware of cases of viable virus coming through treatment processes and infecting people.”
Moderator Benoit Le Roy, CEO of Enviro One, noted: “This crisis is highlighting our deficiencies. Nearly half the water we harvest, treat and convey at great cost is wasted, and we are running out of surface water and ground water. So, some of the obvious measures are to reduce, reuse and augment. But we need the political will, and the financial and risk models to implement that. I believe there is sufficient funding, technology, implementation capability and pedigree to give us water security, so that in times like this, when we have a catastrophe on our hands, we don’t exacerbate the health risks the underserved 30% of the population is exposed to.”
The panellists said that effective implementation of the Department of Water and Sanitation’s Water and Sanitation Master Plan for national water security required stepped up effort and improved public-private collaboration.
“This pandemic has brought our inefficiencies to light, and it will hopefully create more opportunities for government and private sector to sit together and find solutions, drive certain projects and get things done faster,” said Smit.
South Africa’s water supply and treatment challenges, solutions and opportunities will come under discussion at IFAT Africa, the leading trade fair for water, sewage, refuse and recycling, at Gallagher Estate in Johannesburg from July 13 to 15, 2021.
To watch the full webinar discussion, click here
Envisionit Deep AI launches AI solution to help Radiologists and Doctors fight Coronavirus
Dr. Jaishree Naidoo, CEO and Co-Founder of Envisionit Deep AI
Established in 2019, Envisionit Deep AI is an innovative medical technology company that utilises AI to streamline and improve medical imaging diagnosis for radiologists. They are guided by their vision to positively impact the lives of people in Africa by using revolutionary technology to democratise access to healthcare for all.
Envisionit Deep AI has just launched an online version of RADIFY, their AI solution for radiologists and medical doctors. RADIFY, in response to the COVID-19 outbreak, has been offered free of charge to support hospitals, doctors and any other public and private organisation using X-ray in the identification and treatment of COVID-19 pneumonia.
RADIFY was primarily developed to enable radiologists to diagnose more images, more consistently and in less time – whilst prioritising care for people who need it most. One of the biggest challenges facing primary healthcare in South Africa, even before COVID-19, was that they were under resourced and over used. The first line of investigation for pneumonia, and likewise COVID pneumonia, is an X-ray to pick up suspicious features that can be prioritised for further testing.
The volume of X-rays, CT scans and MRI’s generated have always outpaced the number of qualified Radiologists on hand to diagnose and generate patient reporting, creating bottlenecks in the system, often unintentionally leaving urgent cases in the queue for hours on end. RADIFY is capable of labelling 20 different pathologies on X-rays at a rate of 2,000 x-rays per minute, which is 2,000 times faster than a human being!
The chest X-Ray is the first line of investigation for COVID pneumonia because it’s the most readily available, quick and cost-effective imaging tool for the diagnosis of pneumonia – the number one killer of patients with COVID-19. With the impending demand for testing, known shortage of specialists and the costs associated, it’s vital for healthcare to streamline this process. RADIFY can assist healthcare facilities to detect possible COVID-19 pneumonia cases in order of high, intermediate and low probability.
Dr. Jaishree Naidoo, CEO and Co-Founder: Paediatric radiologist who has served the state health care system for 20 years. Pioneered the paediatric radiology subspecialty after becoming the first South African qualified paediatric radiologist in 2010. Previously, head of paediatric radiology at Charlotte Maxeke Johannesburg academic hospital and at Nelson Mandela Children’s Hospital where she commissioned the first paediatric radiology department.
She has chaired the South African Society of Paediatric Imaging (SASPI), the African Society of Paediatric Imaging (AfSPI), serves on the Executive Council of the World Federation of Paediatric Imaging (WFPI) and African Society of Radiology (ASR)
To test the platform, visit https://radify.ai.
Visit: Envisionit Deep AI