scholarly journals Community health workers lensed through a South African backdrop of two peri-urban communities in KwaZulu-Natal

2017 ◽  
Vol 6 ◽  
Author(s):  
Meghan S. White ◽  
Pragashnie Govender ◽  
Helga E. Lister
Keyword(s):  
Community Health ◽  
South African ◽  
Community Health Workers ◽  
Work Experience ◽  
Health Workers ◽  
Monitoring And Evaluation ◽  
Formal Schooling ◽  
Structured Interviews ◽  
Additional Information ◽  
Kwazulu Natal

Background: 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.Objectives: 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.Method: 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.Results: 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.Conclusion: 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.

scholarly journals Community Health Workers Working the Digital Archive: A Case for Looking at Participatory Archiving in Studying Stigma in the Context of HIV and AIDS

2012 ◽  
Vol 17 (1) ◽  
pp. 13-28 ◽  
Author(s):  
Naydene De Lange ◽  
Claudia Mitchell
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Hiv And Aids ◽  
Hiv Stigma ◽  
Digital Archive ◽  
Visual Data ◽  
Community Members ◽  
Work Related ◽  
Kwazulu Natal

Addressing the issue of HIV-stigma is recognised as essential to reducing the spread of HIV and AIDS, enabling community members to access prevention, treatment and care. Often the very people who are able to contribute to solving the problem, are marginalised and do not see ways to insert themselves into dialogues related to combating stigma. Community health workers in rural South Africa are one such group. At the heart of the research discussed in this article is an intervention based on participatory analysis through participatory archiving ( Shilton and Srinivasan 2008 ). Drawing on participatory work with thirteen community health workers in rural KwaZulu-Natal, we use a digital archive containing HIV-stigma visual data - generated five years earlier by youth in the community - to engage the participants in the analysis. Drawing on such participatory work as Jenkins’ participatory cultures framework, we focus on the idea of re-using, re-coding, and re-mixing visual data. One participant stated that “these pictures talk about the real issues faced by our communities”, highlighting the value of resources generated by community members themselves. They also indicate that they “could use [the resources] to teach the cons of stigmatising”. A key concern in work related to visual images (particularly in projects such as ours where a large amount of visual data is produced) is to consider ways of extending its life through the use of community-based digital archives.

Evaluation of the effectiveness of community health workers in the fight against malaria in the Central African Republic (2012–2017)

2019 ◽  
Vol 114 (3) ◽  
pp. 173-184
Author(s):  
Djerandouba Yotobumbeti Ferdinand ◽  
Bessimbaye Nadlaou ◽  
Nzalapan Samuel ◽  
Bekaka Youlet Oscar ◽  
Mbailao Raphael ◽  
...  
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Access ◽  
Central African Republic ◽  
Health Workers ◽  
Preventive Health Services ◽  
Structured Interviews ◽  
Adequate Treatment ◽  
Care Access

Abstract Background This last decade’s ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities.

Geo-Analysis: The Distribution of Community Health Workers in Relation to the HIV Prevalence in Kwazulu-Natal Province, South Africa

2021 ◽  
Author(s):  
Gugulethu Eve Khumalo ◽  
S Ntuli ◽  
E Lutge ◽  
T P Mashamba-Thompson
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Hiv Prevalence ◽  
Policy Framework ◽  
Catchment Population ◽  
Density Mapping ◽  
Kwazulu Natal ◽  
Dot Density ◽  
Gis Software

Abstract Background: The Ward Based Primary Health Care Outreach Team (WBPHCOT) policy framework states that community health workers (CHW)s should be distributed mainly according to poverty lines for each catchment population. We aimed to describe the spatial distribution of CHWs in relation to the HIV prevalence which has been associated with poverty in previous studies.Methods: We utilized geographic information system (GIS) method to visualize the distribution of CHWs in relation to HIV prevalence in KwaZulu-Natal (KZN) districts. Dot density mapping, was used to visualize the random distribution of CHWs in relation to HIV prevalence in the districts. The districts’ HIV prevalence, number of PLWH, CHW: PLWH ratio and poverty scores were mapped using choropleth mapping. MapInfo 17, a GIS software was used to map geospatial presentation of the data.Results: Ten out of 11 KZN districts had more than a required CHW:PLWH ratio of 1:160-267, which indicates a significant shortage of CHWs regardless of the HIV prevalence or poverty scores. Furthermore, our findings showed extensive geospatial heterogeneity with no clear pattern in the distribution CHWs in relation to the HIV prevalence and poverty scores in the districts Conclusion: This finding represents inequalities in the provision of HIV services by the CHWs. It is critical to strengthen response to the HIV epidemic through the well informed and justified distribution of CHWs especially to the poor districts.

scholarly journals Experiences of midwives and community health workers using mHealth to improve services to pregnant women in rural Burkina Faso, Africa

2019 ◽  
Vol 10 (3) ◽  
pp. 57
Author(s):  
Antonia LDC Arnaert ◽  
Norma Ponzoni ◽  
Zoumanan Debe ◽  
Mouoboum Marc Meda ◽  
Noufou Gustave Nana ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Health Center ◽  
Structured Interviews ◽  
Center Staff ◽  
Work Related ◽  
Qualitative Descriptive

Objective: This qualitative, descriptive study explored the experiences of midwives and community health workers (CHWs) using mhealth to improve the care provided to pregnant women living in the rural Diapangou region of Burkina Faso, Africa.Methods: Semi-structured interviews were conducted with 4 CHWs and 4 community health center staff. Transcripts were content analyzed.Results: Despite internet connectivity challenges all participants agreed that mhealth allowed them to provide better maternal care. The service enhanced their practice collectively, through facilitating better follow-up care, promoting communication and collaboration, and facilitated management while simplifying administrative tasks. From a managerial perspective, having access to productivity information allowed for effective oversight and supervision of work-related activities. CHWs perceived additional work responsibilities and an opportunity for growth; however, both CHWs and staff recognized that the exposure to technology allowed them to achieve mastery of basic computer skills.Conclusions: The ‘digital divide’ remains a challenge in low resource settings, thus while findings are promising, Burkina Faso will have to wait to reap the full benefits of digital technology until a supportive infrastructure can be put in place.

scholarly journals Community Health Workers as Influential Health System Actors and not "Just Another Pair Of Hands"

2020 ◽  
Author(s):  
Sumit Kane ◽  
Anjali Radkar ◽  
Mukta Gadgil ◽  
Barbara McPake
Keyword(s):  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Work Experience ◽  
Health Workers ◽  
Human Resources For Health ◽  
Research Question ◽  
Large Body ◽  
Optimal Strategies

Background: Over the last 20 years, community health workers (CHWs) have become a mainstay of human resources for health in many low- and middle-income countries (LMICs). A large body of research chronicles CHWs’ experience of their work. In this study we focus on 2 narratives that stand out in the literature. The first is the idea that social, economic and health system contexts intersect to undermine CHWs’ experience of their work, and that a key factor underpinning this experience is that LMIC health systems tend to view CHWs as just an ‘extra pair of hands’ to be called upon to provide ‘technical fixes.’ In this study we show the dynamic and evolving nature of CHW programmes and CHW identities and the need, therefore, for new understandings. Methods: A qualitative case study was carried out of the Indian CHW program (CHWs are called accredited social health activists: ASHAs). It aimed to answer the research question: How do ASHAs experience being CHWs, and what shapes their experience and performance? In depth interviews were conducted with 32 purposively selected ASHAs and key informants. Analysis was focused on interpreting and on developing analytical accounts of ASHAs’ experiences of being CHWs; it was iterative and occurred throughout the research. Interviews were transcribed verbatim and transcripts were analysed using a framework approach (with Nvivo 11). Results: CHWs resent being treated as just another pair of hands at the beck and call of formal health workers. The experience of being a CHW is evolving, and many are accumulating substantial social capital over time – emerging as influential social actors in the communities they serve. CHWs are covertly and overtly acting to subvert the structural forces that undermine their performance and work experience. Conclusion: CHWs have the potential to be influential actors in the communities they serve and in frontline health services. Health systems and health researchers need to be cognizant of and consciously engage with this emerging global social dynamic around CHWs. Such an approach can help guide the development of optimal strategies to support CHWs to fulfil their role in achieving health and social development goals.

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