A chronic illness is one that continues for a long period of time or recurs over a long period of time. Some of the most common chronic illnesses are asthma and high blood pressure (hypertension).
What are Chronic Diseases?
Chronic illnesses may be inherited, but many lifestyle and environmental factors such as smoking, inappropriate diet, lack of exercise and heavy alcohol consumption significantly increase risks. These factors are reasonably within the control of a well-informed individual, but there are often other factors like poverty, undernutrition during pregnancy and in infancy, and genetic predisposition and ageing, over which the individual has little or no control.
Besides early diagnosis, management and harm reduction, the service aims to prevent illness and promote healthy behaviour.
Priority chronic diseases are: high blood pressure or hypertension, asthma, epilepsy, stroke, renal disease, cancer, obstructive lung disease and Diabetes Type 2. (Diabetes Type 1 is less common and is mostly diagnosed in early childhood.)Most of these illnesses are long-term, and while many are not curable, one can control them.
While people of all ages are affected by chronic illnesses, there is a higher risk of the elderly developing chronic diseases that may result in disability.
Prevention and Management at Primary Health Care Level
At the primary health care level, the service is based on prevention by educating people about the benefits of a healthy lifestyle. Every clinic has staff members skilled to diagnose and manage chronic conditions, from young to elderly patients. Patients can see the same nurse for repeat visits if they come regularly on diabetes/ hypertension or asthma clinic days. They are given a special card or sticker on their folder and this is used to ensure continuity of care. Counselling and compliance are also part of the service. Doctors/medical officers undertake periodic visits from hospitals to clinics to review chronic disease patients.
Arrangements are made by the clinic at the chronic club to minimise patient travel (especially by the elderly) by prescribing supplies of drugs that last six months for stable patients who don’t require regular visits to the clinic. If patients are not feeling well within six months, they must visit their nearest healthcare facility immediately. Staff often facilitate the initiation of chronic clubs and special support groups for people with chronic diseases. In this way, a patient can get more information on special care and health education about their condition.
If complications arise, patients will be referred to the next level of care.
Some examples of how chronic illnesses are prevented, managed and treated are below.
Asthma affects adults and children. It is a chronic inflammation of the airways caused by an allergy. Asthma cannot be cured but can be effectively managed by taking preventive medication daily.
Assessment and treatment of adults are done at primary health care clinics, where patients are examined, special tests are carried out and treatment is initiated. Patients are educated about how to manage their asthma and informed about aggravating factors including smoking, lack of exercise and house dust mites. Patients who have severe asthma attacks may require emergency treatment and referral to a hospital.
Hypertension or high blood pressure is a disease of lifestyle that can be prevented and treated. If the blood pressure remains high for a period, serious complications can develop. These can involve the blood vessels, the heart, the kidneys and the eyes. The result could be a stroke, heart disease or kidney failure and even death. At primary health care level, patients with high blood pressure will be informed about how to improve general health and reduce other risk factors for heart disease e.g. exercise, giving up smoking, alcohol and drugs and cutting down on salt intake. If after this the blood pressure remains high, treatment will be prescribed. Patients must return to the clinic for regular check-ups and medication. Serious complications like stroke, heart disease and kidney failure have to be treated at hospital level.
Chronic care services at all three levels - primary, secondary and tertiary - facilitate getting social service grants to people who need them.
These services are available at all clinics and hospitals throughout the Western Cape.
First-time visitors to the clinic/secondary or tertiary hospital will be asked to fill out a form and a folder will be opened for the patient. You will need to produce your ID book.
A referral letter from the clinic will be required when visiting a hospital. Hospitals ask for your most recent payslip/income assessment (IRP5). You should bring your hospital card if you were previously registered at the hospital.
These facility categories:
|Government Body:||(Western Cape Government)|
Chronic care is free at a primary health care level (day hospital/clinic), but there is a cost involved when visiting a district or tertiary hospital. This cost is based on how much you earn and on how many dependents you have, according to the hospital rating scale.
- Guidelines for the Promotion of Active Ageing in Older Adults at Primary Level (Guidelines, Manuals and Instructions) (File type: pdf; size: 119.38 KB)
- National Guidelines on Primary Prevention of Chronic Diseases of Lifestyle (CDL) (Guidelines, Manuals and Instructions) (File type: pdf; size: 74.27 KB)
- Policy Framework for Non-Communicable Chronic Conditions in Children (Policies) (File type: pdf; size: 210.32 KB)