Citation

Majee W, Schopp L, Johnson L, Anakwe A, Rhoda A, Frantz J. Int. J. Environ. Res. Public Health 2020; 17(9): e3199.

Affiliation

Department of Physiotherapy, Faculty of Community and Health Science, University of the Western Cape, Western Cape, Bellville 7535, South Africa.

Copyright

(Copyright © 2020, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph17093199

PMID

32375417

Abstract

Community health workers (CHWs) have been identified as a key component of the health workforce in South Africa. However, the efficacy of CHW programs continues to be limited by a poor understanding of facilitators and barriers to CHW engagement. This study explores intrinsic and extrinsic factors that CHWs face. We conducted in-depth interviews with 20 CHWs in order to understand the challenges they may face as they implement their duties linked to the primary health care strategy in the Western Cape, South Africa. All interviews were audiotaped, transcribed verbatim, coded and analyzed using NVivo 12. Drawing on narratives of CHWs, we illustrate the complex issues surrounding CHW outreach in poor rural communities. The CHWs identified five key areas of challenges with respect to personal health, gender issues, poor community understanding of CHWs roles, environmental challenges and lack of patient adherence. These all hinder the ability of CHWs to meet their personal and familial needs, as well as those of the community members they support. There is a need to address the intrinsic needs of CHWs in order to ensure their emotional and physical well-being, as well as a need to create an awareness of the roles of CHWs.

Language: en

Keywords

challenges; community health workers; extrinsic; health care services; intrinsic; rural