Transforming Healthcare from the ground up

Transforming health from the ground up

Any pandemic or health challenge cannot be fought without education, says Professor Ramneek Ahluwalia CEO of HIGHER HEALTH in South Africa

South Africa’s alert to the world that it had identified the new COVID variant, Omicron, at the end of last year has pulled its scientists and clinicians into sharp focus. The country has a reputation for innovative thinking and it is tackling coronavirus and HIV in positive ways, the most successful of which is its programme to address health issues and learning for the country’s students via its HIGHER HEALTH organisation.

Run by Professor Ramneek Ahluwalia, HIGHER HEALTH addresses nine areas of focus for 2m students in 26 universities, 50 Technical and Vocational Education colleges, and 9 Community Education and Training colleges by improving their health and wellbeing. Its health, wellness and psychosocial services across 420 campus sites and rural, informal and urban settings in all 52 districts across South Africa identifies students that would benefit from help via a series of questionnaires at the start of all higher level courses.

The key areas are alcohol and drug abuse, mental health, sexual and reproductive health, HIV, STIs and TB, disability, LGBTQI, gender-based violence and now COVID-19. “The important thing is that an educated young South African has a power of influence. Perhaps not many people in the family are educated, so the one with the one who’s educated will pay back in the form of looking a er the entire family,” says Professor Ahluwalia.

“We seek to reduce the e ect of healthrelated conditions that o en challenge students in tertiary studies and which, if le unaddressed, can lead to students delaying the completion and even abandoning their studies. There is a huge challenge with mental health issues among young people so high risk students are linked to care. To date we have referred about half a million young people.”

Deeply ingrained issues

Professor Ahluwalia’s vision is to build families for the future. South Africa has social ills, exacerbated by the legacy of apartheid, that will take time and funds to resolve, but he is convinced that improvement can be accelerated through education. With the support of university Vice-Chancellors and major institutions such as the World Bank

and the European Union, the programme has considerable success in the country.

Referred to as the 2nd curriculum, opportunities for learning and development are o ered to students outside of formal academic studies. It includes a range of campus activities – such as student clubs and societies – and, most importantly it includes a system for volunteers to become peer educators and mentors. The message is that an individual’s health is in their own hands and access to help is broad and available.

“We’re not looking to compete with the current curriculum in health sciences or humanities, “ he says. “Our curriculum runs alongside the academic one to bring help to the community and enable students to continue their education despite their personal challenges.”

The programme expands provision in clinics in higher education locations to help students deal with the issues that arise. HIGHER HEALTH envisages that every campus of every public university and TVET college will in future have either an on-site clinic service or a health, wellness and psycho-social “linkage to services facility”, because students have shown a clear preference for the convenience these facilities a ord while allowing them to stay focused on education.

HIGHER HEALTH also promotes the prevention, early detection and management of non-communicable diseases (NCDs). Not only is type 2 diabetes increasingly common among children and young adults across the world, but South Africa has a specific problem of hypertension among young people. The latest South African Demographic and Health Survey, undertaken in 2016 and published in 2019, found that 17 per cent of young women and 20 per cent of young men (aged 15 to 24 years) had hypertension.

“We’re dealing with many issues in South Africa, such as 8m people living with HIV, a high rate of unplanned teenage pregnancies that lead to a drop o in education, gender-based violence and even human rights issues because South Africa was a colonised country,” Professor Ahluwalia says. “Drugs and alcohol are a huge challenge amongst our youth and across the world, and specifically in the area of higher education. We also have a proper curriculum of understanding LGBTQI because of our throughput in the LGBTQI community. So before they join a company employee wellness programme, students will have had exposure to health and wellness projects from the beginning.”

Professor Ramneek Ahluwalia CEO HIGHER HEALTH

“We seek to reduce the effect of health-related conditions that often challenge students in tertiary studies”

Expanding the programme’s reach

The UN Assembly invited Professor Ahluwalia to speak about good practice in higher education healthcare, and he also spoke about it at the EU Parliament. Di erent UN agencies are in the process of taking the model to several African countries, such as Libya, Malawi and Nigeria. There is also a pilot project at the University of Zimbabwe, and a strong relationship with UN Women around sexual reproductive health issues. HIGHER HEALTH’s policies have helped write an HIV policy for Nigeria that has already been adopted as a test.

“We’re looking to further strengthen and expand partnerships with higher education institutions, government departments, funding and donor agencies, and other organisations in the broad field of student health, wellness and development,” says Professor Ahluwalia.

“Our biggest challenge is how to move into artificial intelligence. We think in future the world will be on a hybrid system and we need to learn to adapt quickly to go online with easily accessible attractive and animated curriculums.”

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