From fields to families: Revolutionising healthcare through communities

This article is by Fikile Dikolomela-Lengene (Sr Fikx), Primary Healthcare Nurse Clinician at the Gauteng Department of Health in South Africa.

The problem: The dissociation of community health services from its communities.
Why it matters: Community health is a vital aspect of realising Universal Health Coverage (UHC) and achieving the Sustainable Development Goals 2030.
The solution: Bridging the gap between health services and the communities they are meant to serve.

In recent years, there has been a growing recognition of the importance of community health in achieving universal health coverage and sustainable development goals. However, one major obstacle in realising this goal is the dissociation of community health services from the communities they serve. This disconnect between health services and communities has resulted in a gap that must be bridged in order to truly achieve development by 2030.

My role in bridging the gap

Working in the healthcare field has always been my passion and I have always dreamed of bridging the gap in community health. So, when I was placed in a semirural area in South Africa that lacked comprehensive quality primary healthcare, I saw it as an opportunity to actively implement policy changes towards universal health coverage. As a primary healthcare clinician, I knew that all talk and no-show would not bring about real change, so I took on the challenge of analysing the community and finding ways to improve their access to healthcare.

💬 Let the author know what you think about connecting community health care with communities by leaving a comment below

South Africa is currently undergoing a healthcare transformational change towards universal health coverage and community care strengthening is a crucial aspect of this change. The concept of universal health coverage is based on the belief that everyone should have access to quality healthcare without financial hardship. However, achieving this goal requires more than just providing healthcare facilities; it also involves addressing the social determinants of health and involving the community in their own healthcare.

I have seen the positive impact of actively involving the community in their own healthcare and addressing social determinants of health.

In my experience working in a semirural area, I have seen firsthand how lack of access to healthcare can affect individuals and families. Many people in these areas work in low income sectors or do manual labour and they often do not have the time or resources to travel distances for healthcare. This leads to untreated health conditions that can worsen over time and have a significant impact on their wellbeing and ability to provide for their families.

Addressing the challenges

One of the main challenges I faced was convincing community members to seek help for their health concerns. Many people had become accustomed to living with pain or discomfort and they did not see the need to visit a healthcare facility. They also had misconceptions about modern medicine, staff attitudes and preferred traditional remedies. This meant that not only did they delay seeking treatment, but when they did come for medical help, their conditions were often more severe; TB infections, as an example, often present late to facilities, which increases death rates from the disease.

To bridge this gap in community health, I had to gain the trust of the community and educate them on the importance of seeking medical help. I organised community health outreach programmes to provide free health screenings and consultations. This not only allowed people to access healthcare conveniently, but it also helped to build a rapport with the community.

One of my goals was also to work closely with community leaders, such as traditional healers and community leaders to understand their beliefs and practices regarding healthcare. By involving them in the conversation, I was able to bridge the gap between modern medicine and traditional remedies. I also collaborated with local organisations and NGOs, i.e. local taxi associations and early childhood centre educators, to provide health education consultations and promote healthy lifestyle practices.

Another challenge in bridging the gap in community health is the lack of resources and infrastructure in semirural areas. Many healthcare facilities are understaffed, underfunded and lack essential medical equipment. This makes it difficult for healthcare workers to provide quality care, leading to a lack of trust in the healthcare system.

To address this issue, I advocated for better resource allocation and worked with local authorities to improve the infrastructure of healthcare facilities in the community. I also trained community health workers to provide basic healthcare services in the community; traditional healers in basic care, i.e. HIV/TB, taxi drivers and ward/street leaders on basic first aid/CPR; early childhood educators on the integrated management of childhood illnesses (IMCI); and expanded a programme on immunisation (EPI) to make healthcare more accessible.

Empowering communities

As a primary healthcare clinician, I believe that it is vital to involve the community in their own healthcare. This not only empowers them, but also allows for better understanding of their needs and concerns. I encouraged community members to form support groups for individuals with chronic conditions, such as diabetes, hypertension, HIV/TB, maternal health and child health, where they could share their experiences and learn from each other.

By actively involving the community in their own healthcare, we were able to identify and address social determinants of health such as poverty, lack of education and inadequate sanitation. We worked with local organisations to provide resources for basic needs like clean water, nutritious food and education on hygiene practices.

Through these efforts, the community's trust in the healthcare system is gradually improving and the number of people seeking medical help early on is a work in progress.

In conclusion, bridging the gap in community health is a challenging but necessary task, especially in countries like South Africa that are working towards universal health coverage. As a primary healthcare clinician, I have seen the positive impact of actively involving the community in their own healthcare and addressing social determinants of health. By working together with local organisations, community leaders and government authorities, we can make significant strides towards achieving comprehensive quality primary healthcare for all.

Let us continue to work towards a future where no one is left behind in terms of accessing healthcare and where “fields come to families” with healthy communities at their centre.

From fields to families: Revolutionising healthcare through communities 1