Open AccessContextual factors affecting the integration of community health workers into the health system in Limpopo Province, South Africa
Author(s) -
Geoffrey Jobson,
Nicolette Naidoo,
Nthabiseng Matlakala,
Gert Marincowitz,
Jean Railton,
James McIntyre,
Helen Struthers,
Remco P. H. Peters
Publication year - 2019
Publication title -
international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.743
H-Index - 31
eISSN - 1876-3413
pISSN - 1876-3405
DOI - 10.1093/inthealth/ihz082
Subject(s) - community health workers , outreach , health care , medicine , nursing , community health , human immunodeficiency virus (hiv) , variety (cybernetics) , qualitative research , economic growth , environmental health , health services , family medicine , public health , sociology , population , economics , social science , artificial intelligence , computer science
Background Community health workers (CHWs) are an essential cadre in the health systems of many low- and middle-income countries. These workers provide a wide variety of services and are key to ongoing processes of task shifting within human immunodeficiency virus programmes in particular. Ward-based outreach teams (WBOTs) are South Africa’s latest iteration of the CHW programme and have been introduced as part of the National Department of Health’s Primary Health Care Re-engineering programme. Methods In order to assess the perceived effectiveness of the WBOTs in supporting the ongoing rollout of antiretroviral therapy, tuberculosis care and patient support, we conducted a qualitative investigation focusing on the perceived successes and challenges of the programme among CHWs, community leaders, healthcare workers and community members in the Mopani district, Limpopo province, South Africa. Results The CHW programme operates across these contexts, each associated with its own set of challenges and opportunities. Conclusions While these challenges may be interrelated, a contextual analysis provides a useful means of understanding the programme’s implementation as part of ongoing decision-making processes.