Abstract
As the South African government re-engineers primary healthcare (PHC), the need for additional information on stakeholders involved in the process has emerged. Of these are community health workers (CHWs), who have been identified as central to PHC success. To profile the current CHWs within KwaDabeka and Clermont in KwaZulu-Natal, to describe their roles and to explore the barriers and enablers influencing their service delivery. A convergent mixed methods design was employed with a sample of CHWs with the use of a survey (n = 53) and two focus groups (n = 10) and semi-structured interviews with four ward councillors (n = 4). Data were analysed statistically and thematically. The profile of CHWs reflected only women with a mixed age range and a majority of 59% who had not completed formal schooling. General work experience as a CHW varied. There were diverse opinions expressed towards the CHW role which related to their job title and identity, supervision, remuneration, growth pathways and psychological and emotional issues. Whilst the National Community Health Worker Profile Framework was established for the CHW programme, there are several factors lacking in the current CHW programme such as a formal growth pathway or formal training to align the CHWs with the National Qualifications Framework. The study findings are essential for the monitoring and evaluation as well as development and refinement of policies that will assist in ensuring adequate rollout of PHC with CHWs.
Highlights
IntroductionPrimary healthcare (PHC) is part of South Africa’s sustainable development plan to establish equitable health and healthcare services
The World Health Organization (WHO) has identified a chronic global shortage of well-trained health workers, creating an essential need for sustainable development strategies for health systems (WHO 2006).Primary healthcare (PHC) is part of South Africa’s sustainable development plan to establish equitable health and healthcare services
The principles of primary healthcare (PHC) are evident in policy development in South Africa from as early as the 1900s, including the National Health Services Commission (NHSC or Gluckman Report) (Republic of South Africa 1945) and the African National Congress’s (ANC) health planning prior to 1994 (ANC 1994)
Summary
Primary healthcare (PHC) is part of South Africa’s sustainable development plan to establish equitable health and healthcare services. The principles of PHC are evident in policy development in South Africa from as early as the 1900s, including the National Health Services Commission (NHSC or Gluckman Report) (Republic of South Africa 1945) and the African National Congress’s (ANC) health planning prior to 1994 (ANC 1994). As the South African government re-engineers primary healthcare (PHC), the need for additional information on stakeholders involved in the process has emerged. Of these are community health workers (CHWs), who have been identified as central to PHC success
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