Abstract

BackgroundCommunity health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.AimThis study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.SettingThe study was conducted in a low socio-economic urban area of the Western Cape, South Africa.MethodsThis study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis.ResultsFive themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective.ConclusionThe challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

Highlights

  • Community health workers (CHWs) are central to driving health promotion and prevention strategies as part of community-based primary healthcare infrastructure

  • Interpretation of the results yielded five themes of challenges experienced by the CHWs in performing their duties

  • Personal challenges revealed ineffective self-management as a theme, and motivation for participating in a selfmanagement programme was characterised by two themes: CHW empowerment and widening CHWs’ perspectives (Table 2)

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Summary

Introduction

Community health workers (CHWs) are central to driving health promotion and prevention strategies as part of community-based primary healthcare infrastructure. The global shortage of health professionals has driven an increase in the use of CHWs as a key cadre to meet the health needs of society. There is a shortage of health workers such as midwives, nurses and physicians.[1] Parallel to this shortage in the workforce is the increase in the disease burden in resource-constrained countries with an increase in communicable and non-communicable diseases.[2]. Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. They themselves have health risk behaviours, which predispose them to non-communicable diseases and need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours

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