Karl Gernetzky: Business Day

THE first group of 25 students has completed the Bachelor of Clinical Medical Practice degree and graduated from the University of the Witwatersrand (Wits) yesterday to enter the health service as a new category of professional known as clinical associate. The new mid-level healthcare professionals will fill a role between doctor and primary healthcare nurse. They are part of the Department of Health's Human Resources for Health 2030 strategic plan, which aims to address weak district healthcare systems and a severe lack of human resources in rural areas. The scope of the clinical associate is intended to fill the healthcare gap in district hospitals and clinics. In such centres, a large proportion of doctors' clinical work relates to emergency care, diagnostic and therapeutic procedures, while that of primary healthcare nurses has to do with chronic and preventative care. The department estimates that about 1 350 clinical associates are required for district hospitals (five per district hospital) and at current output rates it will take 17 years, until 2028, to meet the demand. A total of 79 clinical associates were due to graduate from the universities of Witwatersrand, Walter Sisulu and Pretoria this year. The clinical associates will provide medical services usually conducted by both nurses and doctors. Their work will be similar to that of the physician's assistant in the US health system. Part of their responsibilities will be routine patient consultations and performing common procedures, providing emergency care for acute conditions and managing chronic diseases such as hypertension, diabetes and HIV/AIDS. Director of the Wits Centre for Rural Health, Prof Ian Couper, said clinical associates would in future play a critical role in the rural healthcare system by improving care for patients and supporting doctors, enabling them to engage in greater outreach to clinics. In many parts of Africa, mid-level healthcare professionals formed the "backbone" of the system, he said. Health Minister Aaron Motsoaledi has made assurances that the clinical associates will be "competent, professional members of the public healthcare sector". He said that they would have the necessary knowledge, skills and attitudes to function effectively in the district health system, primarily working under the supervision of qualified medical practitioners, to assist with emergency care, procedures, and inpatient care.