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The role of community health workers in non-communicable diseases in Cape Town, South Africa: descriptive exploratory qualitative study.
- Source :
- BMC Primary Care; 5/21/2024, Vol. 25 Issue 1, p1-14, 14p
- Publication Year :
- 2024
-
Abstract
- Background: Community health workers (CHW) are an integral part of primary health care re-engineering in South Africa. Cape Town is developing community-orientated primary care, with a central role for CHWs. Their role in human immunodeficiency virus, tuberculosis, maternal and child health has been articulated, but is less clear for non-communicable diseases (NCDs). Non-communicable diseases are now a major contributor to the burden of disease. The aim was to explore the current role of CHWs regarding NCDs in the Eastern sub-district of Cape Town, South Africa. Methods: An exploratory descriptive qualitative study made use of non-participant observation and qualitative interviews with CHWs, their managers, and nurse coordinators. Data from nine semi-structured interviews and ten observations were analysed with the framework method and Atlas-ti. Results: The CHWs were embedded in their communities and provided services via support groups, household visits and delivery of medication. They linked people to care with assistance of nurse coordinators. They could also provide physical care in the home. They lacked the ability to counsel people on the risk factors for NCDs and their role in rehabilitation and palliative care was unclear. More nurse coordinators were needed to provide supportive supervision. Inter-sectoral collaboration was weak and hindered CHWs from addressing social issues. More standardised and comprehensive training should equip CHWs for health promotion and disease prevention during household visits. Data collected in the community needed to be analysed, reported on and integrated with data from the primary care facility. This should also contribute to a community diagnosis. Their relationship with facility-based members of the primary health care team needed to be improved. Attention needed to be given to the requirements for and conditions of employment, as well as working hours and remuneration. Some equipment was absent and hindered their services for NCDs. Conclusions: CHWs have the potential to provide a comprehensive approach to NCDs, but community-orientated primary care needs to be strengthened in many of the key areas to support their activities. In relation to NCDs, they need training in basic and brief behaviour change counselling and risk factors as well as in the areas of rehabilitation and palliative care. [ABSTRACT FROM AUTHOR]
- Subjects :
- WORK
RISK assessment
SUPPORT groups
OCCUPATIONAL roles
QUALITATIVE research
PALLIATIVE treatment
CLINICAL supervision
INTERPROFESSIONAL relations
EXECUTIVES
SCIENTIFIC observation
UNOBTRUSIVE measures
INTERVIEWING
STATISTICAL sampling
PRIMARY health care
NON-communicable diseases
SOUND recordings
THEMATIC analysis
CLIENT relations
ATTITUDES of medical personnel
RESEARCH methodology
RESEARCH
COMMUNITY health workers
HEALTH promotion
COUNSELING
HEALTH information systems
PSYCHOSOCIAL factors
EXPERIENTIAL learning
MEDICAL referrals
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 27314553
- Volume :
- 25
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Primary Care
- Publication Type :
- Academic Journal
- Accession number :
- 177392422
- Full Text :
- https://doi.org/10.1186/s12875-024-02424-2