Abstract:
INTRODUCTION : Community health worker 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? As the proactive arm of the health services, community health workers teams provide household and community
education, early screening, tracing and referrals for a range of health and social services. There is little local or
global evidence on the household services provided by such teams, beyond specific disease-oriented activities such
as for HIV and TB. This paper seeks to address this gap.
METHODS : Descriptive secondary data analysis of community health worker team activities in the Ekurhuleni health
district, South Africa covering approximately 280,000 households with 1 million people.
RESULTS : Study findings illustrated that community health workers in these teams provided early screening and referrals
for pregnant women and children under five. 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 and 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 poor communities in South Africa, in addition to general health education. The teams
studied provided a range of activities across many health conditions (mother and child related, HIV and TB, noncommunicable
diseases), as well as social services. These teams provided comprehensive care in a large-scale urban
setting and can improve access to care.
