Noncommunicable diseases such as cardiovascular diseases, diabetes, and cancers account for about 75% of deaths globally. Early detection is crucial in managing the scale of the problem. However, in rural communities, there are often shortages of healthcare workers, long travel distances, and financial barriers. This gap in prevention and early detection is a significant challenge in rural South Africa and Ghana. Biokineticists, regulated health professionals who use exercise scientifically to promote health, prevent disease, and support people living with chronic conditions, could play a greater role in closing this gap.
South Africa has an estimated 1,831 registered biokineticists, mostly in the private sector, and they are scarce in public primary healthcare, particularly in rural communities. A recent research study aimed to understand the role of biokineticists in preventing diseases and identifying health risks early. The study conducted in-depth interviews with 10 biokineticists who had experience in rural outreach or public-sector healthcare. The biokineticists reported routinely conducting physiological screenings, including measuring people's blood pressure, glucose, cholesterol, body mass index, and waist circumference.
These screenings help identify people who may need further assessment, prevention, or referral. The biokineticists also developed simple ways of communicating the risk to patients, such as using a traffic-light approach. However, identifying a problem was only the first step, and the biokineticists described different experiences of follow-up depending on the setting. In the South African Military Health Service, there were more structured and multidisciplinary referral systems. In contrast, during community and rural outreach, screening could identify potential problems, but there was no consistent mechanism for follow-up.
The biokineticists identified several barriers to effective follow-up, including long distances and transport costs. Some people could not afford the taxi fare to the nearest clinic, and others stopped attending exercise or health programs because the services were too far away. Cultural barriers also played a role, with some women uncomfortable during exercise sessions due to traditional dress. The biokineticists acknowledged that cultural and religious considerations were not always incorporated into the programs they delivered.
The main challenge was not a lack of professional capacity among biokineticists but the limited integration of their services into the public primary healthcare system. Biokineticists were already identifying disease risk factors and providing exercise-based prevention. However, fragmented referral pathways, limited public-sector posts, and financial and geographic barriers made it difficult to connect early risk identification with ongoing care.
To address these challenges, the study suggested that biokineticists could join primary healthcare teams, particularly in underserved communities. This could include publicly funded posts, formal referral pathways between clinics and biokineticists, collaboration with community health workers, and sustainable financing for preventive services. The lesson extends beyond biokinetics, highlighting the importance of connecting trained health professionals with financing, referral pathways, transport, community structures, and other health professionals.
The study's findings have implications for Ghana and other countries facing similar challenges. By integrating biokineticists into primary healthcare teams and addressing the barriers to effective follow-up, countries can build a health system that can identify risks earlier and has the structures in place to act. The study's author, Gudani Goodman Mukoma, emphasized the importance of prevention-oriented allied health professionals in the conversation on healthcare reform.
Key points
- Biokineticists can play a greater role in preventing diseases and identifying health risks early in rural communities.
- Limited integration of biokineticist services into public primary healthcare systems hinders effective follow-up and care.
- Publicly funded posts, formal referral pathways, and collaboration with community health workers can help address these challenges.
