Global south healthcare workers empowered to tackle complex diseases

The University of Cape Town (UCT) is pioneering transformative healthcare solutions across the Global South through its innovative Practical Approach to Care Kit (PACK). Developed by UCT’s Knowledge Translation Unit (KTU), PACK is a powerful clinical decision support tool that equips primary healthcare professionals with the resources to make informed, evidence-based decisions about a wide range of common medical conditions. 

With primary healthcare systems globally facing mounting challenges, such as increased co-morbidities, changing climate-driven disease patterns and infectious disease outbreaks, PACK offers a critical lifeline. Used widely in South Africa as Adult Primary Care and in Ethiopia as Ethiopian Primary Healthcare Clinical Guidelines (EPHCG), PACK is now expanding in Brazil and Indonesia, demonstrating its adaptable and far-reaching impact. 

“As an easy-to-use resource PACK provides the latest clinical guidelines and policy at the fingertips of the first-in-line primary healthcare staff.” 

A clinical decision-making tool, PACK is available as a hard copy or eBook and covers over 500 symptoms, syndromes, diagnoses and chronic conditions. 

“PACK follows a symptoms-based approach, prompting the diagnosis of common conditions and facilitating routine care of patients with one or more long-term conditions,” said Dr Ruth Cornick, knowledge translation practitioner at UCT’s KTU. “As an easy-to-use resource PACK provides the latest clinical guidelines and policy at the fingertips of the first-in-line primary healthcare staff.” 

PACK’s implementation across the Global South 

Four recent papers in BMJ Global Health showcase PACK’s role in supporting sustainable, quality primary care in diverse settings. The collection was funded by the National Institute for Health and Care Research (NIHR).  

Dr Cornick, co-author on all four papers explains: “These papers reveal PACK’s resilience across varied healthcare environments. From managing chronic conditions over time to responding flexibly to infectious outbreaks, [this tool] is built to address the multifaceted needs of patients and healthcare systems alike.” 

The papers highlight the success stories of PACK’s implementation: 

• Chronic Respiratory Disease Management in Brazil: The city of Florianópolis witnessed sustained improvements in chronic respiratory disease management, including asthma and emphysema, thanks to PACK. “In our clinics, PACK has, for eight years, proven to be a vital resource driving steady improvements in the management of conditions like asthma and COPD,” said Dr Ronaldo Zonta, a PACK implementation leader in Brazil. “This study confirms PACK’s lasting role in advancing patient care over time.” 
   

• National Scale-Up in Ethiopia: In Ethiopia, PACK was integrated into over 90% of the country’s 3 500 primary healthcare centres over a five-year period. Aklog Getnet from Ethiopia's Ministry of Health, who spearheads PACK’s national implementation, underscores its impact: “The EPHCG has become a standard of clinical care in our primary care facilities.” 
   

• Infectious Disease Outbreak Response in Brazil: PACK’s flexibility was instrumental in Brazil’s response to infectious outbreaks like Zika, COVID-19, and Mpox. “PACK helped improve basic healthcare in Florianópolis during outbreaks,” added Dr Zonta. “It’s a tool that enables healthcare workers to adapt quickly to emergencies by integrating new clinical information.” 
   

• Care for Multiple Long-Term Conditions: A clinical decision support tool using PACK guidance supports efficient, patient-centred care for individuals with multiple long-term conditions, including diabetes, HIV, depression and arthritis. 

UCT’s KTU leader Professor Lara Fairall noted: “These papers document PACK’s enduring presence in health systems across multiple countries and its responsiveness to new healthcare demands, making it a transformative tool for primary care globally.” 

Through PACK, UCT continues to demonstrate leadership in healthcare innovation, improving patient outcomes and empowering primary healthcare workers across the Global South. 

UCT exemplifies its Vision 2030 goal to "Unleash Human Potential to Create a Fair and Just Society" through initiatives like these. By addressing critical healthcare needs across diverse communities, this tool empowers healthcare workers to provide equitable, high-quality care, bridging gaps in healthcare access across the Global South. This vision is at the heart of UCT’s commitment to impactful research and innovation that fosters inclusive, sustainable social transformation.