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A Review of a Community Health Care Workers’ Programme in South Africa

Siziwe O Ngcwabe

,

Krishna K Govender

Siziwe O Ngcwabe 1 Krishna K Govender 1 

  1. Regenesys Business School, Pybus Street, Johannesburg, South Africa 1


Abstract:

 This study explored a Community Health Workers’ (CHW’s) programme from the point of view the CHWs, as well as the non-governmental organizations (NGOs) that managed them, by using a mixed-methods approach. A questionnaire was used to collect data from the CHWs, and semi-structured interviews were conducted with key informants and NGO representatives. It became evident that the CHW’s programmes are not contributing effectively to strengthening the health care system, and are merely playing the role of an ‘emergency response’ for patients suffering from HIV. The CHWs’ roles have never been formalised and CHWs are viewed as “volunteers” within the healthcare system, and therefore not given the necessary support. There is also a clear disconnect between the local health facilities and the CHWs’ programmes. Delays in receipt of payments from the Department of Health (DoH) hamper the NGOs’ ability to run viable organisations, which impacts on their ability to deliver desperately needed health related services. The multiplier effect of the aforementioned results, in further delays in the disbursement of stipends to the CHWs, which creates hardships for some of South Africa’s lowest paid workers who, are already shouldering financial and social burdens, which probably compromises the quality of critical services to those most in need. The overall impression is that as SA approaches the end of the second decade of democracy, it is a matter of urgency that primary health care (PHC) is viewed more seriously by the government and, more specifically the DoH.
Contribution/ Originality
This study documents by way of a case study, the perceptions of Community Health Care workers and NGOs, on their role and importance in fortifying the health-care system in general and primary health-care specifically.

Keywords:


Video:

Reference:

  1. World Health Organisation (WHO), "Planning and implementation HIV and AIDS programme: A step-by-step approach." Available: http://www.searo.who.int [Accessed 28 October 2009], 2009.
  2. Human Sciences Research Council (HSRC), South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2008. Pretoria: Human Sciences Research Council. Available: www.hsrc.ac.za/en/research-outputs/view/2093 [Accessed 30 January 2014], 2008.
  3. Pathfinder International, "Meeting the needs of adolescents living with HIV through home based care- Lessons from Tanzania." Available: www.pathfinder.org [Accessed 08 April 2014], 2006.
  4. Health and Development Networks, "1st Southern African Regional Community Home Based Care Conference. Health and Development Networks." Available: www.dsd.gov.za/Nacca1/index2.php?option=com_docman [Accessed 18 May 2014], 2001.
  5. Department of Health, Negotiated service delivery agreement (NSDA): A long and healthy life for all South Africans. Pretoria: Department of Health, 2010a.
  6. N. Nxumalo, S. Hlahane, and J. Goudge, "The gauteng province community health worker programme: The extent to which it contributes to the provision of comprehensive primary health care." Available: www.globalhealthequity.ca/.../South%20Africa-Final%20Project%20Rep [Accessed 25 April 2014], 2011.
  7. Department of Health, Re-engineering primary health care in South Africa: Discussion paper, November 2010. Pretoria: Department of Health, 2010b.
  8. Department of Health, "Ward-based PHC outreach teams: Implementation toolkit" Pretoria: DOH, 2011.
  9. M. Greeff, Information collection: Interviewing. In: De Vos, A. S. et al. (Editors). Research at grassroots for the social and human service professions, 3rd ed. Pretoria: Van Schaik, 2005.
  10. A. S. De Vos, Combined qualitative and quantitative approach. In A.S. De Vos (Editors). Research at grassroots: A prime for caring professions. Pretoria: Van Schaik, 1998.
  11. L. F. Luna-Reyes and D. L. Andersen, "Collecting and analyzing qualitative data for system dynamics: Methods and models," System Dynamics Review, vol. 19, pp. 271-296, 2001.

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