Walter Sisulu University in South Africa Graduates First Class of Clinical AssociatesCHA/PA Program Completes First Parternship Visit
Walter Sisulu University (WSU), a multi-campus university in Eastern Cape Province, South Africa, will graduate its first cohort of 19 clinical associate (CA) students this fall. The program, launched in 2008 to help grow the capacity for mid-level health care workers in South Africa’s rural health system, is partnering with the Child Health Associate/Physician Assistant (CHA/PA) program at the University of Colorado School of Medicine. The CA program was established under the Twinning Partnership program of the American International Health Alliance, an organization that establishes and manages partnerships between health care institutions in the U.S. and their counterparts in other countries.
In June, Anita Duhl Glicken, MSW, director of the CHA/PA program, and School of Medicine colleagues Cal Wilson and Jonathan Bowser returned from their first partnership trip to South Africa. This December leaders from WSU will visit the University of Colorado Anschutz Medical Campus to experience firsthand the CHA/PA program, meet with faculty and students, and create a workplan for the partnership in South Africa.
During the recent trip to South Africa, Glicken, Wilson, and Bowser met with leaders in WSU’s Faculty of Health Sciences, visited current students, toured three of the district hospitals, and began the process of identifying needs and writing the year’s work plan. Glicken said, “Much of the trip was dedicated to fostering relationships with our partners. We hope this gives us the opportunity to do student and faculty exchanges and support Sisulu’s goal to increase access to health care in underserved communities.”
The program’s initial needs include faculty and curriculum development and program evaluation. Unlike the CHA/PA program, CA students are in didactic classes for only one month a year. Students spend the rest of their time in the district hospitals learning necessary skills taught onsite by clinic doctors and program faculty. Student learning is enhanced through problem-based learning and using their active patients as their case studies. Glicken noted, “This appears to be an innovative and effective methodology that addresses the dual needs of service and learning.” The program recruits 24 students a year from the local population to ensure that students speak Xhosa, the local language. This is important because often the region’s doctors, if not from nearby communities, cannot communicate directly with patients.
According to Glicken, CAs will be a new profession in South Africa and “they will need to differentiate themselves from doctors and nurses by creating their own professional identity and career path. This is a considerable challenge for a profession that is just starting out.”
Glicken estimates that ultimately CAs may end up doing many of the same things that PAs do in the United States, extending their reach beyond district hospitals to rural clinics and working with nursing colleagues to address the extensive shortage of providers in rural and remote areas. According to the most recent 1998 South African census, there is one doctor per 30,000 people living in the Eastern Cape’s rural areas. In order to explore the introduction of this new profession, Glicken and Walter Sisulu colleague Graham Wright recently submitted a concept paper to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) to fund an evaluation of the impact of clinical associate program graduates on quality and access to primary health care, including HIV and AIDS treatment in South Africa.