An Analysis of the Services Provided by Municipal Ward Based Primary Health Care Outreach Teams in an Urban District in South Africa: A Key Contribution Towards Universal Access to Care.

Abstract

Introduction: Municipal Ward based PHC Outreach Teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage?Methods:Descriptive secondary data analysis of team activities in the Ekurhuleni health district, South Africa covering approximately 280 000 households with one million people. This was part of a larger study exploring the effectiveness of these teams.Results:Study findings illustrated that CHWs in these teams provided early screening and referrals for pregnant women and malnourished children. They distributed condoms and chronic medication to homes. They screened and referred for hypertension, diabetes mellitus, HIV and TB. The teams also undertook defaulter and contact tracing, the majority of which was for HIV & TB clients. Psychosocial support provided was in the form of access to social grants, access to child and gender based violence protection services, food parcels and other services.Conclusion:Community Health Workers form the core of these teams and perform several health and psychosocial services in households and to poor communities in South Africa, in addition to general health education. The teams studied provided a range of activities across many health conditions (mother & child related, HIV & TB, non-communicable diseases), as well as social services. Ward based outreach teams provided comprehensive care in a large-scale urban setting and can improve access to care.