Ezintsha, sub-division of Wits Health Consortium (Pty) Ltd

Halving chronic disease-related deaths using science-guided health technologies

Diseases and conditions

A polydisciplinary, science-guided, technology-leveraging comprehensive healthcare service providing benchmarked affordable world-class chronic care to patients in South Africa and beyond.

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Lead Organization

Ezintsha, sub-division of Wits Health Consortium (Pty) Ltd

Johannesburg, Gauteng, South Africa

http://www.wrhi.ac.za

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Non-communicable diseases (NCDs) are responsible for two-thirds of global mortality, with 80% of deaths occurring in low-and-middle-income countries (LMICs). The World Health Organisation (WHO) estimates that Africa will have the greatest increase in deaths due to NCDs by 2030. We propose an integrated, polydisciplinary, science-guided, comprehensive healthcare service that provides benchmarked, world-class care to patients with NCDs within Sub-Saharan Africa. Rigorous information management and analytics platforms will be employed for real-time analysis across the healthcare value chain to performance-manage staff, allowing patient -centric innovative interventions that encourage adherence and contain costs. Performance data reviewed against audited disease-specific metrics will be publicised to facilitate a culture of accountability.The intervention will result in a marked reduction in NCD-related complications associated with poor disease management and provide a model for expansion throughout the region. The solution will be the regions’ benchmark for high quality, lean, transparent and accountable chronic healthcare delivery.

Problem Statement

It was predicted in the early 1990s that type-2 diabetes mellitus would be South Africa’s biggest killer in the next decades, but this was rapidly forgotten as HIV took hold in the 1990s, infecting a fifth of the adult population, fuelling a resurgent TB epidemic, and reducing life expectancy by over a decade.Diabetes has now become the second biggest killer of South African adults after TB. HIV, TB and diabetes all have overlapping epidemiology in terms of vulnerability, but while HIV and TB incidence have recently begun to drop, diabetes is likely to rise as this population ages and as obesity levels rise. High background rates of hypertension and other co-morbidities exacerbate the complications of diabetes, especially in the context of low glucose and blood pressure screening rates, with late presentation.Costs within the healthcare sector are an ongoing expanding challenge. Curative immediate conditions often crowd out more long-term diseases, and the burden on African healthcare workers limits capacity to do screening for asymptomatic diseases. Increasing volumes of different data present a difficult challenge in the healthcare domain where data relating to a patient originates from multiple health information systems. Lack of centralized data platforms make it difficult for every part of the healthcare cascade, including the patient, to actively participate in appropriate interventions and decision-making.

Solution Overview

The Chronic Health Centre will be the highest quality providers of chronic healthcare in the fields of diabetes, hypertension, HIV and associated diseases, including obesity and mental health in sub-Saharan Africa, in both the public and private sector, centred on a convenient bespoke facility, underpinned by a patient-oriented information system that facilitates effective, science-based delivery of services and patient engagement. The Chronic Health Centre will be established to have a fully digitalized data integration platform that facilitates efficient polydisciplinary team work. We will leverage modern technology to revolutionise both patient communication and ongoing education, as well as publicly benchmark our performance outcomes for health funders, external agencies, patients and families.Feedback and learning will include annual measure of the number of chronic patient intake, diagnosed and analysed via our digital platform, and treated (including remote monitoring). Impact over five years, will be the significant contribution to the global monitoring framework for NCDs targets within Sub-Saharan Africa. These include:•Reduction of deaths from the commonest chronic diseases by 25%, •a 25% reduction or containment of the occurrence of high blood pressure, •stop the rise of diabetes and obesity, •have at least 50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes, •An 80% availability of the affordable basic technologies and essential medicines, required to treat major NCDs in both public and private facilities.

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