{"id":2908,"date":"2026-04-15T13:44:54","date_gmt":"2026-04-15T13:44:54","guid":{"rendered":"https:\/\/www.starsfellows.africa\/?p=2908"},"modified":"2026-04-15T13:46:07","modified_gmt":"2026-04-15T13:46:07","slug":"smartpath-roundtable-designing-a-pathway-that-no-woman-falls-through","status":"publish","type":"post","link":"https:\/\/www.starsfellows.africa\/fr\/2026\/04\/15\/smartpath-roundtable-designing-a-pathway-that-no-woman-falls-through\/","title":{"rendered":"SmartPath Roundtable: Designing a pathway that no woman falls through."},"content":{"rendered":"\t\t
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On 4 March, partners from across clinical care, public health, diagnostics, government, and research gathered at the School for Data Science and Computational Thinking at\u00a0Stellenbosch University for the\u00a0SmartPath\u00a0Roundtable: Architecting an Integrated Care Pathway for Maternal\u00a0Anaemia.<\/span>\u00a0<\/span><\/p>\n

The six-hour session brought together a deliberately diverse group \u2013 clinicians, policymakers, academia, community health leaders, and industry partners \u2013 to confront a persistent but preventable challenge: maternal\u00a0anaemia. Despite being both detectable and treatable, too many women continue to fall through the gaps between screening, diagnosis, and care.<\/span>\u00a0<\/span><\/p>\n

SmartPath, a collaborative initiative developed through the African STARS Fellowship at CERI by fellows\u00a0Fezokuhle\u00a0Khumalo, Joel\u00a0Alukwe\u00a0and Harries Molepo,\u00a0seeks\u00a0to address exactly this problem \u2013 not by introducing a single intervention, but by redesigning the entire pathway of care.<\/span>\u00a0<\/span><\/p>\n

As\u00a0Alukwe\u00a0explains, the idea evolved quickly beyond its\u00a0initial\u00a0scope: \u201cBy the time a woman needs IV iron, the system has already failed her multiple times. That pushed us to rethink everything \u2013 to go\u00a0earlier, and\u00a0build one connected pathway from awareness through to treatment.\u201d<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Structuring the Conversation: From Problem to Pathway<\/span><\/b>\u00a0<\/span><\/p>\n

The roundtable was designed not as a series of presentations, but as a working session.<\/span>\u00a0<\/span><\/p>\n

The morning opened with framing discussions on the burden of iron deficiency and the\u00a0SmartPath\u00a0model, before moving into a multidisciplinary panel focused on a central question: why is the current system failing women \u2013 and what would it take to fix it?<\/span>\u00a0<\/span><\/p>\n

What\u00a0emerged\u00a0quickly was a shared recognition that maternal\u00a0anaemia\u00a0is not a single-point failure, but a system-wide breakdown. \u201cMaternal\u00a0anaemia\u00a0is a multi-level problem \u2013 it starts early, and frontline healthcare workers are often not trained to\u00a0recognise\u00a0the symptoms,\u201d said Prof Vernon Louw, Executive Head of the Department of Medicine at the Faculty of Medicine and Health Sciences, University of Stellenbosch.<\/span>\u00a0<\/span><\/p>\n

Across the panel, participants pointed to gaps at every stage \u2013 awareness, detection, monitoring, treatment, and follow-up.<\/span>\u00a0<\/span><\/p>\n

\u201cIron deficiency develops long before pregnancy, but symptoms are often dismissed as normal,\u201d noted Khumalo. \u201cBy the time women are diagnosed, the condition has often progressed.\u201d<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Where the System Breaks Down<\/span><\/b>\u00a0<\/span><\/p>\n

A recurring theme throughout the discussion was that knowledge \u2013 or lack of it \u2013 sits at the\u00a0centre\u00a0of the problem. \u201cThe biggest problem is awareness,\u201d said Nomonde\u00a0Tengwa,\u00a0Innovation Hub Lead at mothers2mothers. \u201cMothers are given iron tablets but don\u2019t understand why they are important.\u201d<\/span>\u00a0<\/span><\/p>\n

This gap extends beyond patients. \u201cCommunity health workers are the first point of care, but if they don\u2019t understand the importance, they can\u2019t communicate it,\u201d she added.<\/span>\u00a0<\/span><\/p>\n

Even communication itself presents challenges. \u201cThere isn\u2019t even a word for iron in some languages,\u201d Prof Louw noted, underscoring how deeply structural some of these barriers are.<\/span>\u00a0<\/span><\/p>\n

At the clinical level, the limitations of current diagnostic approaches were also clear. \u201cHaemoglobin\u00a0testing is widely used, but it misses almost half of iron deficiency cases,\u201d said Prof\u00a0Louw. This means many women are only\u00a0identified\u00a0once\u00a0anaemia\u00a0is already advanced \u2013 a point echoed across both panel and\u00a0SmartPath\u00a0team insights.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

From Detection to Action<\/span><\/b>\u00a0<\/span><\/p>\n

If the problem is fragmentation, the proposed solution is integration.\u00a0SmartPath\u00a0is built around a simple but powerful idea: closing the loop \u2013 connecting awareness, diagnosis, treatment, and follow-up into a continuous system of care.<\/span>\u00a0<\/span><\/p>\n

\u201cWhen the loop works, it starts before pregnancy,\u201d explained Khumalo. \u201cFrom adolescent screening and awareness, through antenatal care, to community monitoring and escalation when needed.\u201d<\/span>\u00a0<\/span><\/p>\n

Central to this model is the role of point-of-care diagnostics. \u201cPoint-of-care testing would make a huge difference,\u201d said Prof\u00a0Louw. \u201cIf you can diagnose and act immediately, you don\u2019t lose the patient.\u201d<\/span>\u00a0<\/span><\/p>\n

The current system often requires women to return for results \u2013 something many cannot do. \u201cPatients are told to come back, but they don\u2019t \u2013 they face long queues and lose a day of work,\u201d he added.<\/span>\u00a0<\/span><\/p>\n

SmartPath\u00a0instead proposes a shift from a one-time prescription model to a continuous care pathway, supported by community health workers and structured follow-up.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Designing for Reality: The Breakout Sessions<\/span><\/b>\u00a0<\/span><\/p>\n

In the afternoon, participants moved into breakout groups to stress-test the\u00a0SmartPath\u00a0pilot against real-world conditions.<\/span>\u00a0<\/span><\/p>\n

The focus was practical:<\/span>\u00a0<\/span><\/p>\n

    \n
  • What would make this work in a busy antenatal clinic?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
      \n
    • What evidence would policymakers need?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
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      • How could the model be sustained beyond donor funding?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n

        These discussions surfaced the realities of implementation.<\/span>\u00a0<\/span><\/p>\n

        \u201cPrimary healthcare is already stretched \u2013 integration is key,\u201d said Megan Marais from the Western Cape Department of Health. \u201cIf we want real change, we need to build on processes that already work.\u201d<\/span>\u00a0<\/span><\/p>\n

        Participants\u00a0emphasised\u00a0the need to avoid adding complexity. \u201cWe don\u2019t need to reinvent the wheel \u2013 we should use the resources we already have,\u201d added Natasha Macey, Medical Advisor from Acino.<\/span>\u00a0<\/span><\/p>\n

        This directly shaped\u00a0SmartPath\u2019s\u00a0evolving design. \u201cThe roundtable pushed us toward a leaner approach,\u201d Harries Molepo noted. \u201cFocusing on only the most essential data and steps, rather than overburdening already stretched systems.\u201d<\/span>\u00a0<\/span><\/p>\n

        \u00a0<\/span><\/p>\n

        The Challenge of Implementation<\/span><\/b>\u00a0<\/span><\/p>\n

        While education and awareness were repeatedly highlighted, there was also a strong call to move beyond discussion. \u201cWe have the intellectual capacity and willingness in this room to solve this problem,\u201d said Dr\u00a0Benjamin\u00a0Botha. \u201cBut education alone is not enough \u2013 we are at the interface of implementation.\u201d<\/span>\u00a0<\/span><\/p>\n

        His conclusion captured a broader sentiment across the room: \u201cTalk is cheap \u2013 implementation is what matters.\u201d<\/span>\u00a0<\/span><\/p>\n

        Cost and sustainability also\u00a0emerged\u00a0as critical considerations. \u201cPoint-of-care testing is not yet part of the guidelines \u2013 so the question is, who pays?\u201d\u00a0noted Prof\u00a0Tulio de Oliveira, Director of the Centre for Epidemic Response and Innovation (CERI).<\/span>\u00a0<\/span><\/p>\n

        At the same time, there was recognition that investment upfront could reduce long-term costs, particularly by preventing complications such as postpartum transfusions.<\/span>\u00a0<\/span><\/p>\n

        \u00a0<\/span><\/p>\n

        Looking Ahead<\/span><\/b>\u00a0<\/span><\/p>\n

        The immediate next step for\u00a0SmartPath\u00a0is the launch of a pilot in selected antenatal clinics, designed to generate evidence on feasibility, acceptability, and impact.<\/span>\u00a0<\/span><\/p>\n

        \u201cThe goal is to test this in real-world settings,\u201d Harries Molepo explains, \u201cand refine the model before any broader rollout.\u201d If successful, the implications could extend far beyond maternal\u00a0anaemia. \u201cThe core architecture \u2013 point-of-care diagnostics, decision support, and structured follow-up \u2013 is adaptable,\u201d Molepo notes. \u201cIt could be applied to other conditions where care is currently fragmented.\u201d<\/span>\u00a0<\/span><\/p>\n

        Ultimately, the\u00a0SmartPath\u00a0Roundtable made one thing clear: the challenge is not whether maternal\u00a0anaemia\u00a0can be addressed \u2013 but whether systems can be designed to do so consistently. Or, as Nomonde\u00a0Tengwa\u00a0put it: \u201cWe need to ensure the patient truly understands, before she leaves.\u201d<\/span>\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

        On 4 March, partners from across clinical care, public health, diagnostics, government, and research gathered at the School for Data Science and Computational Thinking at\u00a0Stellenbosch University for the\u00a0SmartPath\u00a0Roundtable: Architecting an Integrated Care Pathway for Maternal\u00a0Anaemia.\u00a0 The six-hour session brought together a deliberately diverse group \u2013 clinicians, policymakers, academia, community health leaders, and industry partners \u2013 […]<\/p>\n","protected":false},"author":2,"featured_media":2909,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-2908","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/posts\/2908","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/comments?post=2908"}],"version-history":[{"count":5,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/posts\/2908\/revisions"}],"predecessor-version":[{"id":2914,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/posts\/2908\/revisions\/2914"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/media\/2909"}],"wp:attachment":[{"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/media?parent=2908"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/categories?post=2908"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.starsfellows.africa\/fr\/wp-json\/wp\/v2\/tags?post=2908"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}