Health Advocacy Key to Addressing Health Systems Failures

BY: .

UKZN’s College of Health Science’s Teaching and Learning Office recently hosted Dr Prinitha Pillay of the Rural Health Advocacy Project who presented an interactive workshop for academics and students on how to teach health advocacy.

Advocacy is an active promotion of a cause or principle to change policies and practices, make broader impact, reform institutions, alter power relations and change attitudes/behaviours. It is a critical skill for any healthcare worker.

Pillay said it was important for lecturers to teach students advocacy. ‘Students need to be taught when to speak out and made aware that they will be protected in doing so. They also need to recognise that there is no one size fits all, knowing different routes to take and alternative strategies are key,’ Pillay said.

Key components include the knowledge and application of legal and ethical frameworks, knowledge of mechanisms that exist - internal within the Department of Health and external to the State.

Internally, the National Managements Complaints protocol and newly formed Office of Health Standard Compliance were important, said Pillay. External mechanisms include the public protector, SA Human Rights Commission, unions, regulatory bodies like the HPCSA, advocacy organisations and the media.

According to Pillay universities need to design a social justice curriculum. ‘At university level a situational analysis must be conducted. Simultaneous reform of the curriculum and its institutional context is important, as it cannot be divorced. A platform to advocacy is the validation of new curriculum and practices that include the contribution of students, and faculty and external stakeholders, including communities.’

According to Pillay, advocacy should start early on in school and as educators, academics should want their students to always recognise public interest. They should be able to reflect on whose interests are served, the best way to deliver services and how they could change things.  ‘That reflection on assumptions, biases and values prior to action will help reduce a clumsy cross cultural intervention.’

Pillay is an experienced clinician in Infectious Diseases and an activist.  She is leading a project VOICE to teach advocacy skills to students, educators and in-service providers. She has worked for Doctors without Borders/Medecins Sans Frontieres (MSF) in different countries including: Lesotho, Sudan, South Sudan, Libya, India, Sierra Leone and in both rural and urban South Africa.

A guide on how to report healthcare challenges is available at http://www.rhap.org.za/wp-content/uploads/2014/12/RHAP-Voice-Manual-Nov-2014.pdf, it provides tools, tips and strategies for healthcare workers.

Nombuso Dlamini