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Innovating to improve primary care in less developed countries: towards a global model
  1. Lara Fairall1,
  2. Eric Bateman1,
  3. Ruth Cornick1,
  4. Gill Faris1,
  5. Venessa Timmerman1,
  6. Naomi Folb1,
  7. Max Bachmann2,
  8. Merrick Zwarenstein3,
  9. Richard Smith4
  1. 1Knowledge Translation Unit, University of Cape Town Lung Institute, South Africa
  2. 2Health Services Research, Norwich Medical School, University of East Anglia, UK
  3. 3Schulich School of Medicine & Dentistry, Western University, London, Canada
  4. 4Board of Trustees, ICDDR, B, London, UK
  1. Correspondence to Dr Lara Fairall, Knowledge Translation Unit, University of Cape Town Lung Institute, George Street Mowbray, Cape Town, South Africa 7700; lara.fairall{at}uct.ac.za

Abstract

One of the biggest problems in global health is the lack of well trained and supported health workers in less developed settings. In many rural areas there are no physicians, and it is important to find ways to support and empower nurses and other health workers. The Knowledge Translation Unit of the University of Cape Town Lung Institute has spent 14 years developing a series of innovative packages to support and empower nurses and other health workers. PACK (Practical Approach to Care Kit) Adult comprises policy-based and evidence-informed guidelines; onsite, team and case-based training; non-physician prescribing; and a cascade system of scaling up. A series of randomised trials has shown the effectiveness of the packages, and methods are now being developed to respond cost-effectively and sustainably to global demand for implementing PACK Adult. Global health would probably benefit from less time and money spent developing new innovations and more spent on finding ways to spread those we already have.

  • Accessible
  • Affordable
  • Delivery
  • Global Health
  • Terminal Care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjinnov-2015-000045

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