It took Community Health Workers many years of continuous struggle to win recognition and permanent employment in their field of work. The struggle of CHWs is still far from being over since the South African government, through its Department of Health (DOH), does not want to accept CHWs as legitimate public servants. The services the CHWs continue to give to the communities are recognised as the best services by different communities, especially to the elderly who cannot reach health facilities when they are sick. The carers have proven that health care service at doorstep of the ordinary community members is possible.
The government is not only failing CHWs but it is also failing the whole country and the health system as they have stated that CHWs are the foundation of Primary Health Care and the new National Health Insurance that will soon to be introduced in the country.
In 2016 the Labour Court ruled that Gauteng CHWs are employees of the Department of Health but this led to the Department outsourcing CHWs to a private company called Smart Purse Solution. this was an escape plan for
the Department from taking full responsibility to employ CHWs on a permanent basis. In 2018, CHWs were again favoured by the findings of an Arbitrator who was brought in to settle the dispute between CHWs and the Department.
The Arbitrator gave an award, that CHWs are permanent employees on an indefinite contract at the Public Health and Social Development Sectorial Bargaining Council. The government has since then failed to implement the
award from the PHSDSC. CHWs across the country will be signing 12 months fixed-term contracts again in March 2020 and continue to be unrecognised and exploited by the government, through the DOH.
The facts have favoured CHWs against the Department of Health and the communities appreciate the work they deliver every day to patients while Primary Health Care statistics is also shows this, daily. Is South Africa waiting for a big health outbreak to realise the need for CHWs? Is prevention not better than cure? Why doesn’t our country invest in CHWs to better the health system?