The perceptions of community health care workers regarding Primary Health Care outreach services in the Tshwane Sub-district, Gauteng Province

Abstract

Introduction: The National Department of Health in South Africa piloted ward-based primary health care outreach services in 2011. The service is part of Primary Health care (PHC) re-engineering and it is provided by a team that includes community health care workers. Aim: The aim of this study was to explore the perceptions of ward-based community health care workers (CHWs) regarding primary health care outreach services in Tshwane sub-district. Research method: A qualitative ethnographic design was followed to explore the perceptions of CHWs. A purposive sampling method was used and data collected by means of interviews. Unstructured face to face interviews and reviews of site documents were used to generate data. Data was analysed using thematic analysis. Findings: The four main themes were revealed as: household activities performed by CHWs, working conditions, benefits to the community, and acknowledgement by the Department of Health. The findings included dissatisfaction of the CHWs with their current working conditions, especially the need to be full-time workers, earning a living wage in the form of a salary, not a stipend, and the aspiration to development by furthering their careers. Despite this dissatisfaction, the findings further revealed appreciation of the service by communities and reduction of the workload at clinics. It was recommended that the Department of Health recognise the service of CHWs in the form of permanent employment and formalise the career paths of CHWs. Furthermore, it was recommended that clinic staff members begin to portray positive working relationships and attitudes towards CHWs. Conclusion: Despite the dissatisfaction among the CHWs, the communities and health facilities are benefiting from this service.