Cargando…

Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa

Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 a...

Descripción completa

Detalles Bibliográficos
Autores principales: Malatji, Hlologelo, Griffiths, Frances, Goudge, Jane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021906/
https://www.ncbi.nlm.nih.gov/pubmed/36962793
http://dx.doi.org/10.1371/journal.pgph.0000881
_version_ 1784908609124040704
author Malatji, Hlologelo
Griffiths, Frances
Goudge, Jane
author_facet Malatji, Hlologelo
Griffiths, Frances
Goudge, Jane
author_sort Malatji, Hlologelo
collection PubMed
description Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 and 2011 are attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with community-orientated primary health care principles. Using a case study approach, we studied CHW teams in seven primary healthcare facilities located in semi-urban and rural areas of Gauteng and Mpumalanga provinces, South Africa. We collected data using in-depth interviews involving facility managers, CHW supervisors, community representatives and key informants, and focus groups and observations of CHWs. The implementation of community-orientated health interventions remains complex. In the different sites, there were efforts to integrate the views of stakeholders (e.g., political leaders) into the implementation of the CHW programmes. However, many residents were more concerned about access to housing than health services. The CHWs services’ were found to be generally comprehensive, however inefficient training, supervision and mentorship limited their effectiveness. The multidisciplinary approach to care, as introduced by some sites, helped enhance the knowledge and skills of some of the CHWs on complex health topics. The roll out of community orientated primary health care services is crucial in a resource-constrained setting like South Africa. However, significant socio-economic issues disrupt community involvement and the effective provision of services. Governments need to provide sufficient funds for training, supervision, supplies and remuneration to help overcome these barriers.
format Online
Article
Text
id pubmed-10021906
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-100219062023-03-17 Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa Malatji, Hlologelo Griffiths, Frances Goudge, Jane PLOS Glob Public Health Research Article Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 and 2011 are attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with community-orientated primary health care principles. Using a case study approach, we studied CHW teams in seven primary healthcare facilities located in semi-urban and rural areas of Gauteng and Mpumalanga provinces, South Africa. We collected data using in-depth interviews involving facility managers, CHW supervisors, community representatives and key informants, and focus groups and observations of CHWs. The implementation of community-orientated health interventions remains complex. In the different sites, there were efforts to integrate the views of stakeholders (e.g., political leaders) into the implementation of the CHW programmes. However, many residents were more concerned about access to housing than health services. The CHWs services’ were found to be generally comprehensive, however inefficient training, supervision and mentorship limited their effectiveness. The multidisciplinary approach to care, as introduced by some sites, helped enhance the knowledge and skills of some of the CHWs on complex health topics. The roll out of community orientated primary health care services is crucial in a resource-constrained setting like South Africa. However, significant socio-economic issues disrupt community involvement and the effective provision of services. Governments need to provide sufficient funds for training, supervision, supplies and remuneration to help overcome these barriers. Public Library of Science 2023-02-14 /pmc/articles/PMC10021906/ /pubmed/36962793 http://dx.doi.org/10.1371/journal.pgph.0000881 Text en © 2023 Malatji et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Malatji, Hlologelo
Griffiths, Frances
Goudge, Jane
Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title_full Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title_fullStr Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title_full_unstemmed Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title_short Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa
title_sort community-orientated primary health care: exploring the interface between community health worker programmes, the health system and communities in south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021906/
https://www.ncbi.nlm.nih.gov/pubmed/36962793
http://dx.doi.org/10.1371/journal.pgph.0000881
work_keys_str_mv AT malatjihlologelo communityorientatedprimaryhealthcareexploringtheinterfacebetweencommunityhealthworkerprogrammesthehealthsystemandcommunitiesinsouthafrica
AT griffithsfrances communityorientatedprimaryhealthcareexploringtheinterfacebetweencommunityhealthworkerprogrammesthehealthsystemandcommunitiesinsouthafrica
AT goudgejane communityorientatedprimaryhealthcareexploringtheinterfacebetweencommunityhealthworkerprogrammesthehealthsystemandcommunitiesinsouthafrica