A Shot in the Arm


    Our global collaborations have given healthcare in other countries a massive boost and saved lives.

    Improving the quality of Primary Health care in low and middle class income countries

    Developing countries all over the world face the complex challenge of providing vital care for people while creating healthcare systems that are robust, effective and flexible. Our researchers have impacted on the lives of millions of people by helping to develop and evaluate the innovative health care guidelines and training that make up the Practical Approach to Care Kit (PACK).


    The story started over 15 years ago, when Professor Max Bachmann and our team of researchers at the Norwich Medical School teamed up with the Knowledge Translation Unit at the University of Cape Town to improve the delivery of primary care services in South Africa. The lack of knowledge, training and resources of frontline health professionals was severely restricting the delivery of care. And national life expectancy in the country had dropped from 61 years to 52 years, mainly because of the HIV epidemic.


    Together we focused on developing guidelines and training for the integrated care of tuberculosis and other lung diseases, and doing research to show that this was effective, cost effective and feasible at scale. Our work ultimately resulted in the creation of PACK, a comprehensive clinical decision support manual, coupled with educational outreach to primary health care workers. The initiative was such a success that it was rolled out for the care of HIV/AIDS and other sexually transmitted infections too, enabling antiretroviral treatment to be provided to over 4.4 million South Africans with HIV who would have died without it. The guidelines and training were then extended even further to cover diabetes, high blood pressure and depression in adults, as well as child health conditions.


    PACK has been promoted internationally through a partnership with the British Medical Journal. To date 185,765 manuals have been distributed and 30,000 health workers trained in seven countries, including South Africa, Botswana, Malawi, Nigeria, Ethiopia, Brazil and China. The PACK Movement - a social movement to promote access to quality primary healthcare for all through PACK – has almost 500 members from 35 countries. These innovations are improving the health of millions of people worldwide.

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    UEA Perspectives

    “People in low and middle-income countries needlessly suffer illness and death because they don’t get basic affordable primary healthcare. Our work with health services and healthcare workers in the developing world has helped to improve the lives of millions of people worldwide” – Professor Max Bachmann, Professor of Health Services Research, Norwich Medical School.

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