The innovation

Kheth’Impilo means “Choose Life” in the Nguni languages. This not-for- profit organisation is questing for an AIDS-free generation in our time. How? By using a unique model of patient advocacy with training and mentoring for community healthcare workers.

Winner of the Pioneering Approaches Award at the 2014 Inclusive Healthcare Innovation Summit

The action

Dr Ashraf Grimwood has been a frontline warrior against HIV/AIDS since the late 1980s, when he worked with Aboriginal communities in Australia.

It’s a war that won’t easily be won – in South Africa alone, more than six million people are living with HIV. But the country has come a long way since the days of AIDS denialism, and antiretroviral treatment now allows many to lead healthy lives. Dr Grimwood has also seen a dynamic shift in the way people cope with the diagnosis and management of the condition.

“We want to see an AIDS-free generation in our time,” he says. “The overall goal is complete virological suppression. That means people have to be treated, they have to stay on treatment and we have to have continuous monitoring of their viral count.”

The scale of the AIDS pandemic, along with the increasing risk of TB co-infection, puts a heavy burden on public-system healthcare professionals, potentially compromising access to prevention, treatment and support.

But Kheth’Impilo is helping to fill the gap, by providing specialised education on HIV and TB management for clinical staff, and by training, mentoring and deploying “cadres” of healthcare workers within affected communities.

Matriculants are carefully selected for training as pharmacist assistants, social auxiliary workers, community adherence workers, quality nurse mentors and phlebotomists, who are attached to community clinics once qualified. Much
of the work focuses on the needs of mothers, and of children who have been orphaned or made vulnerable by the epidemic.

These innovative teaching programmes support transformation in the public health sector by creating employment and mobilising funding. But Kheth’Impilo also has an innovative model of patient advocacy, which brings one-on-one counselling to people living with HIV/AIDS.

This comes in the form of patient advocates, many of whom are themselves HIV-positive. They are shoulders to lean on, bearers of information, facilitators of treatment regimens and lifestyle management. More than that, they are friends in troubled times and agents of personal change. “They stand up for the rights of patients,” says Grimwood. “A lot of people with HIV/AIDS are able to get on with their lives and careers. But they’re still vulnerable. They need someone to help them in their darkest moments.”

Today Kheth’Impilo employs more than 900 staff (including 450 patient advocates) and reaches over 200 000 patients and families in high-HIV districts in the Eastern Cape, KwaZulu-Natal, Mpumalanga and the Western Cape. The programme is unique in its approach to HIV- and TB-management, and 79% of the patients supported by a patient advocate remain in care and virologically suppressed at 60 months after treatment initiation.

But Grimwood, is far from complacent: “The virus is incredibly dynamic [and] destroys on a daily basis. If we let our guard down, it’s going to continue to wreak havoc in our communities.”

At the same time, after almost three decades on the frontline, Grimwood remains energised and inspired by the people he works to help. “I meet new patients, I give people diagnoses every day,” he says, “and I’m amazed by the resilience of humanity.”

For more information visit: khethimpilo.org

The lesson learned

Don’t neglect your own health and wellness in the quest to improve the well-being of others. Innovation in healthcare depends on people who are fit and healthy enough to take on the magnitude of the task.

ALL THE WINNING INNOVATIONS IN HEALTHCARE: Nominations poured in. There were so many innovators to consider and commend. But, at the close of the first Inclusive Healthcare Innovation Summit (IHIS) in Cape Town 2014, a winner (or two) was finally chosen from the finalists in each of the five award categories. Meet the prize-winning people and projects here… Collaborative Reimagining Award: → Operation Sakuma Sakhe  → Electronic Continuity Of Care Record (eCCR) / Transforming the System from the Inside Out Award: → Parents Guidance Centre Reakgona  → AfriTox / Minding the Gap Award: → Umthombo Youth Development Foundation /Inclusive Technology Award: → Praekelt Foundation / Pioneering Approaches Award: → Kheth’Impilo

Adapted from the 2014 Health Innovator’s Review, compiled by Inclusive Healthcare Innovation, a joint initiative between the Bertha Centre for Social Innovation & Entrepreneurship at the University of Cape Town (UCT) Graduate School of Business, and the UCT Faculty of Health Sciences.