The Role of Community Health Workers in South Africa

Written by Amanda Zheng

“Integrating Community Health Program.” U.S. Agency for International Development, 5 Feb. 2018, www.usaid.gov/what-we-do/global-health/cross-cutting-areas/integrating-community-health-program.

In the United States, when we think of healthcare we usually imagine a doctor’s office or hospital. However, this is not easily accessible to much of the world. In rural areas such as South Africa, 40% of communities have to travel an average of 25 km to get access to treatment.

Although it would be ideal to simply build more hospitals in rural areas, this is much easier said than done. First, there is the lack of patients as the average occupancy rate of rural hospitals is only 60.5% leading to an average 3.4% operating loss. In addition, there are critical shortages of highly educated health professionals due to an increasing demand for health care services, emigration of health workers, and population growth. The patient-to- primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas.

In these communities, the first line of medical help for many citizens are Community Health Workers. First, what is a Community Health Worker (CHW)? They are key members of the community who work with local healthcare systems that share language, culture, and connections with the local patients. The “task shifting” of primary care functions from professional health workers to community health workers works to efficiently use the human resources currently available and improve the health of millions at reasonable cost. The impact of CHWs is especially important in areas such as sub-Saharan Africa which has an extreme lack of medical personnel and supplies. Sub-Saharan Africa carries “24% of the world’s burden of illness, but only has 3% of the health care workers and 1% of the worldwide financial resources for health care” . Of the estimated 1.3 million CHWs worldwide, it is estimated around 70% of CHWs are female.

There are four tasks of CHW as described by the Global Health Delivery Project at Harvard. Let’s look at their benefits the local community and how Mobility can help link CHWs to patients:

1. Assisting individuals and communities to adopt healthy practices:

Currently, CHWs’ responsibilities include linking people to resources, providing informal counseling and health services (such as monitoring blood pressure and providing first aid), and making home visits. Even though CHWs are a main source of healthcare in rural areas, it is still difficult for them to access remote areas as they are often traveling on foot.

Using Mobility, CHWs can receive a scooter to travel through a microfinancing loan that would allow the user to reach more patients in a wider radius. By increasing the reach of CHWs, Mobility can strengthen the link between rural patients with chronic conditions and pharmacies providing medication. Our network can open easy access to essential treatments regardless of location, price, or ability to travel.

2. Conducting outreach to ensure access to care:

A large part of the impact of CHWs falls in its home visits to patients. As the only source of medical attention many rural patients get, these visits are essential. However, as stated above, it is extremely difficult to travel on foot to many of these locations.

While distributing medicine as a part of Mobility, CHWs can also contribute to the research by collecting valuable data. Because CHWs have a strong connection with the locals, they are more likely to be trusted to obtain information that can help city planners and improve future healthcare systems.

3. Providing or supporting primary and chronic care:

In the status quo, patients need to actively seek care by traveling dozens of kilometers to clinics and hospitals. However, the chronic illness patients in most need of regular treatments or checkups are either not aware of the details of their conditions and medications.

There is currently no way for CHWs to ensure chronic patients are receiving treatment. However Mobility will enable CHWs to take a proactive measure to regularly deliver the correct medication straight to the patients’ doors.

4. Advocating structural changes related to community health needs:

CHWs provide a familiar language and culture to an otherwise obscure medical situation for rural patients. The ultimate goal is for patients and CHWs to develop trust in their relationship.

By emphasizing one-on-one connections between patients and CHWs through frequent visits to deliver chronic medication, this stronger bond can become the new normal. The healthcare experience will be with a familiar friend instead of an unknown doctor.

Ballard, Madeleine. “Community Health Workers.” Feb. 2018, https://www.globalhealthdelivery.org/files/ghd/files/ghd-c11_chw_concept_note.pdf.

Works Cited

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3. Keeru, Lynda. “Women in the Changing World of Community Health Work.” CHW Central, 26 June 2017, chwcentral.org/twg_article/women-in-the-changing-world-of-community-health-work/.
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