Abstract
Background:The provision of universal health coverage is acknowledged as a priority goal for healthcare systems globally. In South Africa, the National Health Insurance system has been endorsed as a funding model for the provision of universal health coverage for South Africans. Community Health Workers have contributed to better universal health coverage outcomes in many countries. A study in India revealed that coverage of health care practices is positively correlated with the knowledge level of Community Health Workers. In South Africa, there is a difference in the duration of training of Community Health Workers in different provinces, especially in Vhembe District.Objective:This study aimed to assess Community Health Workers’ knowledge regarding their roles and describe their challenges within the context of National Health Insurance.Methods:Qualitative design was used to collect data from 33 participants who formed five focus groups comprising six to eight members each. Ethical principles of research such as permission, informed consent, voluntary participation and anonymity were observed. Data was analysed using thematic data analysis technique guided by Tesch open coding method.Results:The findings revealed that Community Health Workers lack adequate knowledge regarding the roles they are expected to play within Ward Based Outreach teams. Some of the challenges they face include transportation to clients’ homes and poor reception in households.Conclusion:A review of the South African Qualification Authority health promoter unit standards is recommended coupled with the mentorship of Community Health Workers by retired nurses to help them understand their roles better.
Highlights
December 12, 2017, marks the anniversary of the first United Nations resolution, calling countries to provide universal health care coverage by 2030 [1]
The provision of universal health care services in South Africa is facilitated by the adoption of Primary Health Care (PHC) re-engineering strategy with its 4 pillars, which include among others Ward Based Outreach Teams (WBOT)
The first objective assessed the knowledge of Community Health Workers (CHWs) regarding their roles within the WBOT context of PHC re-engineering; whereas the second objective described the challenges of CHWs within the WBOT context of PHC re-engineering
Summary
December 12, 2017, marks the anniversary of the first United Nations resolution, calling countries to provide universal health care coverage by 2030 [1]. Community health work was introduced in South Africa as home-based care in the 1940s, focusing on the home care of HIV/AIDS patients [4]. Evidence from countries such as Brazil, India, etc., demonstrate that services offered by CHWs have helped in the decline of maternal and child mortality rates; and have assisted in decreasing the burden and costs of Tuberculosis (TB) and Malaria worldwide [1]. In South Africa, the National Health Insurance system has been endorsed as a funding model for the provision of universal health coverage for South Africans. In South Africa, there is a difference in the duration of training of Community Health Workers in different provinces, especially in Vhembe District
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