Healthy Jozi: A Staged Approach to Better Workplace Food Choices and Chronic Disease Screening and Linkage to Care

Background

Inner-city Johannesburg, South Africa, features health challenges of many middle-income countries, with rapidly urbanised people changing diet while facing overcrowding, noise, pollution, crime, drugs, unemployment and other issues. South Africa has ongoing success in addressing the HIV epidemic using newly developed practices and approaches. We aim to apply what we have learned to find people with other chronic diseases caused by lifestyle changes, especially hypertension and diabetes, which now account for most treatable deaths in South Africa. Treatment is free, easy to take and readily available but most people do not know they have hypertension or diabetes, so do not take the first steps to look after themselves and seek care. Meanwhile, fast food has become readily available and cheap, contributing to an unfolding obesity epidemic in South Africa. Numerous diverse workplaces in the inner city, surrounded by clinics and general practitioners, allow for an opportunity to link sick people to healthcare. We will focus on a screening programme in the inner-city workplaces and design a friendly, innovative employee programme that screens for chronic diseases and assists people to link to care at nearby health facilities. We will also design an inner-city specific healthy food education programme to introduce people to alternative food options, including where they can buy affordable healthy food nearby.

Aims

1. Develop candidate public health approaches in inner-city Johannesburg workplaces for improved screening and linkage-to-care for chronic diseases (Aim 1a)

2. Opportunities for healthier food choices (Aim 1b),

3. Rigorously test this workplace package (Aim 2).

Project plan

Our programme will be designed with employees, managers, local community groups and non-governmental organisations involved in food activism, including diabetic groups, as well as people involved in public health screening programmes and medical insurance – groups with a stake in making screening successful – to understand behaviours related to health screening, health seeking and food consumption behaviour.

We have assembled a strong group of researchers, led by the University of Liverpool, with South African researchers at University of the Witwatersrand, who have been working in inner city Johannesburg for decades. They will be assisted by accomplished nongovernmental advocacy organisations, working on issues of health service delivery quality improvement, patient activism and food advocacy.

We will test the programme in workplaces to ascertain if this new design improves screening uptake and linkage and encourages improved food choices, while also measuring the intervention costs so that we can make recommendations to policy makers, donors, governments and funders. We will leverage this opportunity to develop early career researchers in implementation science.

If successful we will have identified ways to start addressing hypertension, diabetes and possibly obesity epidemics, using approaches that worked for HIV, and we will have begun the process of tackling the challenge of this complex array of lifestyle conditions, which in future is likely to include other challenges such as mental illness, chronic lung disease and sleep disorders.

Publications and output

To access publications and other outputs relating to this project, see our publications webpage.

Funding organisations

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