Many More Community Healthcare Workers are needed across South Africa


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Community Health Workers (CHWs) have played a critical role and been on the frontline of helping government deliver health services to communities for many years. Most CHWs work as volunteers in working class areas where health facilities are far from the people and mobile clinics are available only once in a week.

In the early 2000s, when South Africa started having extremely high cases of HIV/AIDS and Tuberculosis, the majority of the people who suffered from these pandemics was working class communities. There was a great need for CHWs during this time, who were previously known as ‘care givers’. A large number of ‘Home Based Care’ NGOs were established and CHWs began to work on the frontline, educating people and help prevent the spread of HIV/AIDS and Tuberculosis. They also provided home based care services, including adherence support for people diagnosed with chronic diseases and defaulters.

In 2011, the World Health Organisation reported that close to 70,4% of maternal deaths in South Africa were associated with HIV infection. Half of all the deaths were children under 5 years old. Child mortality continues to be a problem in South Africa, with working class communities most affected. CHWs have continued to serve their communities and have extended their services to provide antenatal and postnatal care in these communities. This includes identifying and referring pregnant women to health facilities in the earlier stages of their pregnancies. This has helped reduce mother-to-child transmission of HIV, and has raised conciousness on the wellbeing of children and the importance of vaccinations. The presence of CHWs within working class communities has changed the health lifestyle of these communities for the better.

On 30 March 2020, President Cyril Ramaphosa announced that South Africa will deploy 10 000 fieldworkers (CHWs) who will assist with door-to-door campaigns, screening, testing and tracing of coronavirus cases during this COVID-19 pandemic. But Gauteng has an estimated 9 000 CHWs, and there is a shortage of CHWs in all provinces. Clearly 10 000 CHWs or ‘fieldworkers’ won’t cover the needs of the country.

In his presentation to the Minister of Health Zweli Mkhize, Chairperson of the Ministerial Advisory Group on COVID-19, Prof Salim S. Abdool Karim, later said South Africa needs more than 28 000 CHWs, and that CHWs can play a vital role to reduce the virus in all four stages of response. Instead of 28 000 more, South Africa needs close to 80 000 permanent CHWs on the ground, who will deliver basic health care services to communities on a daily basis. This will help with health education of COVID-19 and all the precautions that need to be followed. It will also help reduce the stigma of COVID-19 and limit the impact of fake news.

Mr President needs to realise the critical role CHWs play in fighting coronavirus. Recognition of CHWs as permanent foot soldiers of primary healthcare services will also open doors to many unemployed citizens of South of Africa.

Tshepo Matoko is a Community Healthcare Worker based in Tsakane, in the Eastrand of Gauteng. He is also the Secretary of the Gauteng Community Health Care Forum.

This article was submitted on 13 May 2020. You may republish this article, so long as you credit the authors and Karibu! Online (www.Karibu.org.za), and do not change the text. Please include a link back to the original article.

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