Former AIHA partners at the University of Pretoria (UP) Faculty of Health Sciences in South Africa convened a Clinical Associates Research Symposium October 6, 2023, at their campus in Hatfield, Pretoria.
Clinical Associates are mid-level medical professionals akin to Physician Assistants in the United States. In 2008, South Africa introduced this new medical cadre as a solution to the country’s severe shortage of health workers, particularly in rural and underserved communities. The Bachelor of Clinical Medical Practice (BCMP) – the degree Clinical Associates must earn – is a 3-year program that focuses on clinical skills to assess patients, make diagnoses, determine appropriate treatments, and undertake minor surgical procedures under the supervision of medical officers.
The symposium brought together Clinical Associates and other relevant health system stakeholders working to advance clinical knowledge and improve the quality of patient care throughout the country. In addition to practicing Clinical Associates, presenters included representatives from South Africa’s National Department of Health, Gauteng District Department of Health, hospital leadership, clinical managers, university lecturers, and students. The event showcased the critical and transformative contributions Clinical Associates are making to South Africa’s health system through not only their expertise, but also their effective integration into multidisciplinary healthcare teams. Click here to view a recording of the event.
Only three universities in South Africa – University of Pretoria, University of the Witwatersrand, and Walter Sisulu University – offer BCMP programs. From 2010 to 2018, AIHA provided technical assistance to all three, including establishing twinning partnerships linking each one with a U.S. university (Arcadia University, Emory University, and University of Colorado – Denver, respectively) through our PEPFAR-supported HIV/AIDS Twinning Center.
In addition, AIHA implemented cross-cutting programs to support the nascent profession under the aegis of the Clinical Associates Forum, which addressed needs related to professional association building, advocacy, career-pathing, student assessment, mentoring by volunteer preceptors, data collection, and coordinated research. The Forum also provided the three universities and other stakeholders an opportunity to meet and discuss best practices and lessons learned and to coordinate strategies for the future of the programs and the profession itself. A crucial element of this was AIHA’s support for the Professional Association of Clinical Associates in South Africa (PACASA).
“As PACASA continues to advocate for Clinical Associates in South Africa, in November 2021, the South African Public Protector released a report endorsing PACASA’s concerns about the National Department of Health’s neglect of the profession and outlining corrective actions,” explains Sanele Ngcobo, Ph.D., MPH, BCMP, a lecturer in UP’s Faculty of Health Sciences and an organizer of the research symposium.
“We welcome the (July) appointment of Dr. Luvuyo Bayeni as Chief Director of Human Resources for Health at the National Department of Health,” Dr. Ngcobo, says. “His presence at the Clinical Associate Research Symposium has sparked hope within our profession given his extensive experience working alongside Clinical Associates.”
Before returning to pursue advanced degrees at UP, Dr. Ngcobo served as a Clinical Associate at Osindisweni Hospital near Durban and Tembisa Hospital in Gauteng. Stressing the important role the association plays in supporting the Clinical Associates profession, he says, “PACASA remains actively involved in annual rural health conferences and is currently in the planning stages for its next annual general meeting, which will coincide with the 2024 rural health conferences. The founders of PACASA continue to make significant contributions to the profession, with Miss Aviwe Mgobhozi achieving the milestone of becoming the first South African-trained Clinical Associate to serve as the head of the BCMP training division at Wits University.”
Clinical Associate Daniela Sefora Goeieman, Associate Lecturer at University of the Witwatersrand (Wits), is set to earn her Master of Philosophy (MPhil) degree from Stellenbosch University in December 2023, having completed a postgraduate diploma in addiction prevention and treatment there in 2020. Goeieman worked as a Clinical Associate at Kopanong Hospital in Vereeniging and the Gauteng Department of Health, and was Clinical Associate, research assistant, and lecturer with the Community Orientated Substance Use Programme at UP’s Department of Family Medicine.
In addition to her work at Wits, Goeieman serves as a member of the board of the Rural Health Advocacy Project, a partnership between the Wits Centre for Rural Health and the Rural Doctors Association of Southern Africa.
“I was appointed to represent PACASA because most of Clinical Associates practice in rural areas, making us key contributors to information and advocates for health policies that are geared to improving equity, quality, and access to care for rural communities,” she says, explaining that her efforts are currently focused on ensuring that the proposed policy for universal health coverage in South Africa – especially the budgeting model – includes the young profession in its human resources strategy and considers the complex difficulties of providing healthcare in rural areas.
From 2015 to 2018, Goeieman served as PACASA’s Head of Strategic and Organizational Development. “Through my role at PACASA, I learned how to create strategies, organize and plan activities, and submit required reports,” she says, noting that with AIHA support she also worked to develop a database of graduated Clinical Associates to track work placements and other employment details to better inform activities and advocacy.
“You changed our lives!” Goeieman says. “I am proud to say my professional development and ability to be an advocate for the profession is through the support that was shown by John Capati and Loveness Satande, and the great mentorship I received from Amanda Wortmann, during their tenure at AIHA.”
It is individual success stories like Sanele and Daniela that are a true testament to the value of AIHA’s twinning model and the long-term sustainability of the work we have been doing for the past 30 years. We are so proud to have supported them in a small way on their journey to improving access to quality healthcare services for the people of South Africa and we are proud to have played a role in the development of the Clinical Associates profession.