Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa.

Nyalunga, S. L.N.; Ndimande, John V.; Ogunbanjo, GA; Masango-Makgobela, A.; Bogongo, T.

doi:10.1080/20786190.2019.1613061

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…However, due to contextual challenges, the delivery of the intervention is, in practice, not feasible via CHWs linked to a PHC facility. This is in line with other studies examining CHW systems in South Africa and other LMIC settings [ 20 , 35 – 37 ], as CHWs have become a cadre of health workers to whom various new tasks are assigned, without necessarily much consultation or consideration of their capacity in terms of time, working conditions or skills.…”

Section: Discussionsupporting

confidence: 88%

“…This route through community-based organisations is not without its own challenges, such as higher costs and possibly limited potential for scalability and sustainability compared to that of the public sector. Implementation of CHW programmes through community-based organisations has also been criticised for lacking accountability [ 20 ], and it ignores the need to the strengthen community health systems through the public sector [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…CHWs are each responsible for a specified number of households in their community, and their tasks include, for instance, promoting antenatal care attendance, the immunisation of children, and treatment adherence in the case of chronic illnesses. CHWs are managed by team leaders who are trained nurses [ 20 , 21 ] and receive formal training before being deployed in the communities. While some formalised processes are in place, there are notable gaps between policy and implementation in terms of the WBOT system and PHC more generally [ 19 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

Klingberg

Sluijs

Jong

et al. 2021

Pilot Feasibility Stud

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Background Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. Methods A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. Results The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Conclusions Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

Klingberg

Sluijs

Jong

et al. 2021

Pilot Feasibility Stud

View full text Add to dashboard Cite

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“… 35 A recent study determined that social conditions do have an impact on the mental health of an individual. 36 Although there is evidence that CHWs are not always safe when they enter the homes of patients with mental health problems, 37 concern for safety was not raised in this study. Rather, CHWs observed the need to understand the patient and how to communicate depending on the mental health status of the patient, and CHWs in this study demonstrated empathy towards their clients’ mental health needs.…”

Section: Discussionmentioning

confidence: 73%

Challenges experienced by community health workers and their motivation to attend a self-management programme

Johnson

Schopp

Waggie

et al. 2022

African Journal of Primary Health Care & Family Medicine

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Background: Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.Aim: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.Setting: The study was conducted in a low socio-economic urban area of the Western Cape, South Africa.Methods: This study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis.Results: Five themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective.Conclusion: The challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

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“…Although limited, available evidence of CHW experiences from rural South Africa largely mirrors the global literature. CHWs in South Africa identify training (Nyalunga et al, 2019), supervision (Assegaai & Schneider, 2019), remuneration, and logistical factors (Austin-Evelyn et al, 2017) as issues shaping their work lives.…”

mentioning

confidence: 99%

Are we listening to community health workers? Experiences of the community health worker journey in rural South Africa

Katzen

Skeen

Dippenaar

et al. 2022

Research in Nursing & Health

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Access to healthcare in developing countries remains a challenge. As a result, taskshifting to community health workers (CHWs) is increasingly used to mitigate healthcare worker shortages. Although there is solid evidence of CHW program effectiveness, less is known about CHWs' experiences of becoming and then working daily as CHWs-information that should play an important role in the design of CHW programs. We examined the experiences of a group of CHWs working in a government-run CHW program in South Africa's rural Eastern Cape Province.Semistructured qualitative interviews (N = 9) and focus groups (N = 2) focusing on motivations for becoming a CHW and experiences of working as CHWs were conducted and thematically analyzed. Three themes were identified: (1) becoming a CHW, (2) facing challenges in the field, and (3) gaining community acceptance through respect and legitimacy. In this study, CHWs were motivated by altruism and a desire to help their community. They faced a range of challenges such as limited training, lack of supervision, equipment shortages, logistical issues, and clinics with limited services. Respect and legitimacy through community acceptance and trust is crucial for effective CHW work. CHWs in this study described how confidentiality and their own persistence facilitated the process of gaining respect and legitimacy.CHWs have a unique knowledge of contexts and requirements for successful programs and greater efforts are needed to include their perspectives to improve and develop programs. Recognition is needed to acknowledge the significant personal input required by CHWs for programs to be successful.

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Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa.

Cited by 12 publications

References 16 publications

Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

Challenges experienced by community health workers and their motivation to attend a self-management programme

Are we listening to community health workers? Experiences of the community health worker journey in rural South Africa

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