Abstract
BackgroundCommunity healthcare workers (CHWs) play a vital role in linking health facilities and communities where there is a high prevalence of childhood disorders. However, there is limited literature on whether this cadre of workers is adequately prepared for this task.AimThis study explored the training needs of CHWs working in the field of childhood disorders and disabilities to improve the future training of CHWs and service delivery.SettingThis study was conducted in an urban district in KwaZulu-Natal, South Africa.MethodsThis qualitative study used purposive sampling to recruit 28 CHWs and 4 key informants working in health facilities in one district of the KwaZulu-Natal Province in South Africa. Data were collected via semi-structured interviews and focus groups. Interviews were conducted in the first language (isiZulu) of the CHWs. Data were analysed thematically. Ethical clearance was obtained from a Biomedical Science Research Ethics Committee.ResultsThere was an evident lack of knowledge and skill in managing childhood disorders and disabilities by CHWs. Enablers and restrictors affecting service delivery were highlighted. Moreover, the training needs of CHWs have raised critical concerns because of the variable nature of training and perceived inadequate preparation for service delivery. The challenges raised were also generic to the holistic role of CHWs and not particularly specific to the CHW role in childhood disorders and disabilities.ConclusionTraining of CHWs in childhood disorders may assist in improving CHWs’ competence and confidence in the field, which may enhance service delivery and thus may assist in contributing towards improving healthcare for children at this level of care.
Highlights
Community healthcare workers (CHWs) play a vital role in linking health facilities and communities where there is a high prevalence of childhood disorders
The South African government revitalised its focus on primary health care (PHC)[1] in a concerted effort to manage childhood disorders and physical disabilities to achieve the goal of providing universal health care and ensuring a long and healthy life for all
Community health workers in this study reported that they received no cooperation from health facility staff, as they view them as insignificant, which is possibly because of the http://www.phcfm.org non-integration of CHWs into the health system and confusion about their role
Summary
Community healthcare workers (CHWs) play a vital role in linking health facilities and communities where there is a high prevalence of childhood disorders. Ward-based outreach teams (WBOTs), school health teams and district clinical specialist teams form pillars of the re-engineered PHC that is aimed at strengthening health promotion, disease prevention, curative, rehabilitative and early detection services.[2,3,4] Ward-based outreach teams include generalist community health care workers (CHWs)(for the first time) as part of the formal structure of the health service under the guidance of a facility-based nurse.[2,3,5] Using this approach, the CHWs form the foundation of community-based PHC services, that is, extending health out of the facility through integration in assigned communities, households, educational institutions, referral networks and in providing services to persons in their homes.[2,3,5,6] In South Africa, CHWs have been seen as important collaborators who assist the professional health care teams to deliver and strengthen services.[2,3,6,7] For example, CHWs are expected to provide information, education and appropriate home-based care, carry out community profiling and assessments of households to identify those with difficulties or who are at risk and to facilitate referrals from the community to the clinic.[2,3,5] Community health workers are expected to complete follow-ups, provide psychosocial support, provide maternal and child health care, assist with problem-solving around minor health care issues and social determinants of health issues as well as to support screening as part of school health teams, Phila Mntwana centres (that is child community diagnostic centres) and to support the continuum of care of the multidisciplinary team with households assigned to them.[2,3,8,9]
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