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Harm reduction in practice - The Community Oriented Substance Use Programme in Tshwane.

Andrew Scheibe1, Shaun Shelly, Johannes Hugo

  • 1COPC Research Unit, Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Tshwane. andrew.scheibe@gmail.com.

African Journal of Primary Health Care & Family Medicine
|June 6, 2020
PubMed
Summary
This summary is machine-generated.

The Community Oriented Substance Use Programme (COSUP) in South Africa provides community-based harm reduction services for substance use. Sustainable success requires health system integration and sustained political commitment.

Keywords:
Behavioural health managementCommunity oriented primary careFamily medicineHarm reductionPrimary healthcarePublic healthSubstance use

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Area of Science:

  • Public Health
  • Substance Use Disorders
  • Harm Reduction

Background:

  • The Community Oriented Substance Use Programme (COSUP) is South Africa's first publicly funded, community-based response to illegal substance use.
  • It employs a systems thinking, public health, and clinical care harm reduction approach.

Purpose of the Study:

  • To outline the essential components, challenges, and successes of initiating and delivering evidence-based, community-oriented substance use health and care services.

Main Methods:

  • The Community Oriented Substance Use Programme (COSUP) is implemented in four Tshwane Metropolitan Municipality regions.
  • Quantitative and qualitative data were gathered and triangulated from various program documents.

Main Results:

  • COSUP contributed to policy development and established 17 service sites in Tshwane, engaging 169 organizations.
  • Services included counseling, care linkage, and opioid substitution therapy for 1513 adults, with significant needle/syringe distribution and capacity building in harm reduction.

Conclusions:

  • COSUP presents a feasible, evidence-based, public-health alternative to abstinence-only substance use programs.
  • Scaling up requires health system integration, patient-centered care, affordable medications, multisectoral partnerships, capacity development, investment, and political commitment.