An innovative approach to patient care aimed at stemming chronic diseases of lifestyle such as cardiovascular disease (CVD), cancer, diabetes and hypertension in South Africa has received the thumbs up, and will usher in a new era for practicing medicine in the country.

Spearheading the initiative dubbed iChange4Health is generics pharmaceutical company, Pharma Dynamics – an advocate for preventative healthcare – that views the approach as an important intervention in reducing the epidemic of chronic diseases, which already account for close to 40% of deaths in SA annually.

The change will come by way of a specially developed training resource, called Brief Behavioural Change Counselling (BBCC), which will educate medical students on how to appropriately advise patients about lifestyle modification in order to reduce the risk of chronic diseases.

From this year onwards, the BBCC programme will be incorporated as part of the undergraduate and postgraduate curriculum of the Division of Family Medicine at various universities throughout the country.

CEO of Pharma Dynamics, Erik Roos, says in practical terms, a family physician or GP will now be trained to not only deal with a patient’s symptoms, but to tackle the root cause of an illness from the outset.

“Doctors will be armed with the necessary knowledge and skills to better evaluate a patient’s overall health status, based on diet, level of physical activity, smoking, alcohol intake, and other risk factors – even if a patient looks healthy, a thorough assessment will be done, followed by recommendations.

It is high time that more emphasis is placed on prevention and that the role which healthcare practitioners can play is given renewed emphasis. The BBCC Programme will enable GPs to be more effective in changing chronic diseases of lifestyle risk behaviours and improving self-management among patients with existing chronic conditions,” said Roos.

“There is a considerable body of research that strongly supports the benefits of lifestyle change as a means of decreasing the risk of chronic diseases of lifestyle. Even modest changes in behaviour can substantially reduce morbidity and mortality. The objective is to ensure that every consultation counts, especially when it comes to helping people adjust their lifestyles,” continued Roos.

The BBCC resource guide, which includes a comprehensive manual for healthcare practitioners and various other info booklets aimed at patients, was funded by Pharma Dynamics and researched and developed by the Chronic Disease Initiative for Africa (CDIA), Stellenbosch University and the Cancer Association of SA (CANSA). BBCC has also been hailed by SA’s top doctors as an important intervention in reducing the epidemic of chronic diseases.

Among the prominent members of SA’s medical fraternity that have endorsed the programme include Head of Department of Medicine at the University of Cape Town (UCT), Prof Bongani Mayosi; Head of Family Medicine and Primary Care at Stellenbosch University, Prof Bob Mash; Head of Diabetic Medicine and Endocrinology at UCT, Prof Dinky Levitt; and CEO of the Heart and Stroke Foundation, Prof Pamela Naidoo.

Postgraduate Programme Coordinator: Division of Family Medicine and Primary Care at Stellenbosch University, Dr Zelra Malan, who is one of the stalwarts of the programme, says since the start of the pilot in 2014 at the university, more than 600 undergraduate medical students and about 40 doctors that are specialising in Family Medicine have already been trained in Brief Behavioural Change Counselling, and the response to date has been overwhelming. Eight other universities that offer Family Medicine have this year also incorporated the BBCC into their curricula.

“It’s not just doctors that are being trained, but nurses and other healthcare staff too. We have already trained several medical officers from the public sector in the Western Cape and the Department of Health has requested that we include BBCC in a training programme for chronic care, which is a great vote of confidence from government,” said Dr Malan.

“I believe BBCC is a step in the right direction. If we continue to deal with risk factors in a piecemeal way then the results will be inconsequential. Finally, a holistic multi-behavioural intervention has been created which should be embraced by not only doctors-in-training, but all healthcare practitioners, particularly those working in the primary care sector,” continued Dr Malan.

Similar programmes have been rolled out in Australia, Canada and the US, but it’s a first for Africa. Doctors in Namibia and Botswana have also been exposed to BBCC, and its positive effect is bound to spill over into other regions.

The BBCC training programme has been registered as a short course offered through Stellenbosch University twice yearly, which is open to all healthcare practitioners. For more info regarding the BBCC Programme, visit

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