Zethu Makatini
Bessie Makatini Foundation, Durban,
South Africa
Abstract Title:
Disrupting Dementia Care in Low-Resource Settings: Community-Driven Innovation and Early-Diagnosis Pathways from the Bessie Makatini Foundation, South Africa
Biography:
Zethu works in the NHS as a psychotherapist, supporting older people living with dementia and mental illness. Her commitment to dementia care is personal: her mother was diagnosed with dementia in South Africa in 2009. While living in the UK, she visited her regularly until her death in 2012 and saw the limited dementia services available, particularly in low-income communities there. In 2015, she founded the Bessie Makatini Foundation. The foundation supports people living with dementia in underserved and rural communities. From the UK, she works with colleagues in South Africa to provide dementia awareness, support and training.
Research Interests:
Dementia care systems in low- and middle-income countries are characterised by late diagnosis, limited specialist capacity, and high caregiver burden. Conventional models designed for high-income contexts are often impractical in rural and township communities. The Bessie Makatini Foundation (BMF), supported by the Dementia Trust, has introduced a disruptive, community-centred approach that challenges traditional assumptions about who can deliver dementia care, how early identification can occur, and how families can access specialist services. Operating with minimal resources, BMF has trained ordinary community members as Dementia Champions, enabling awareness, basic screening, psychosocial support, and structured referral pathways to Memory Clinics and social services. This model has produced outcomes typically associated with well-funded programmes in high-income countries. Methods: BMF’s disruptive model integrates three components: 1. Task-shifting through Dementia Champions — equipping non-professionals to deliver dementia awareness, identify suspected cases, and support families. 2. Community-to-clinic referral pathways — linking underserved communities directly to memory clinics at hospitals and clinics, bypassing traditional bottlenecks. 3. Hybrid caregiver support groups — accessible in rural, peri-urban, and online formats, providing psychoeducation, emotional support, and coping strategies. This presentation synthesises operational data, caregiver feedback, and emerging findings from collaborative research with UKZN. Results: BMF’s approach has disrupted conventional dementia care in several ways: • Shifting expertise to the community: Dementia Champions have enabled earlier symptom recognition and reduced reliance on scarce specialist personnel. • Breaking access barriers: Structured referral pathways have increased access to formal diagnosis and improved engagement with social workers and community health services. • Transforming caregiver experience: Support groups have reduced isolation, improved dementia knowledge, and strengthened coping and resilience. • Achieving high impact with low cost: The model demonstrates exceptional scalability and cost-efficiency, enabling expansion into rural areas with minimal infrastructure. Conclusion: BMF’s work illustrates how disruptive innovation rooted in community mobilisation, task-shifting, and strategic partnerships can transform dementia care in low-resource settings. By redefining who can deliver dementia support and how families access specialist services, BMF offers a replicable model for LMICs seeking sustainable, community-driven solutions.
