Community health worker perspectives on a new primary health care initiative in the Eastern Cape of South Africa.

Katherine Austin-Evelyn,Anthony Mutiti,Wafaa M El-Sadr,Miriam Rabkin,Tonderayi Macheka,Thomas Dlamini,Judith Mwansa-Kambafwile,Matthew P Fox

doi:10.1371/journal.pone.0173863

Abstract

BackgroundIn 2010, South Africa’s National Department of Health launched a national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to provide a preventive and health-promoting community-based PHC model. A key component of rPHC is the use of community-based outreach teams staffed by generalist community health workers (CHWs).MethodsWe conducted focus group discussions and surveys on the knowledge and attitudes of 91 CHWs working on community-based rPHC teams in the King Sabata Dalindyebo (KSD) sub-district of Eastern Cape Province.ResultsThe CHWs we studied enjoyed their work and found it meaningful, as they saw themselves as agents of change. They also perceived weaknesses in the implementation of outreach team oversight, and desired field-based training and more supervision in the community.ConclusionsThere is a need to provide CHWs with basic resources like equipment, supplies and transport to improve their acceptability and credibility to the communities they serve.

Highlights

In 2010, South Africa’s National Department of Health (NDoH) launched a national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection
The community health workers (CHWs) we studied enjoyed their work and found it meaningful, as they saw themselves as agents of change
Clinics were purposively selected for inclusion in the study, and the 93 CHWs assigned to these clinics were invited to participate in both focus group discussions (FGDs) and a survey on knowledge and attitudes related to Re-engineering Primary Health Care (rPHC). 91 agreed to participate in the FGDs and survey; the two CHWs who declined to participate did not specify their reasons

Summary

Introduction

In 2010, South Africa’s National Department of Health (NDoH) launched a national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using communitybased outreach teams (known in South Africa as ward-based outreach teams or WBOTs). In 2010, South Africa’s National Department of Health launched a national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to provide a preventive and health-promoting community-based PHC model. A key component of rPHC is the use of community-based outreach teams staffed by generalist community health workers (CHWs)

Methods

Results

Discussion

Conclusion