Community Health Workers

Who is a Community Health Worker (Unompilo)?

This is a member of community who has been selected in trust by his/her community to enter their homes and assist them to improve their health status. This is an extension of the Primary Health Care, which reaches out to the people at household level.

Where are community health workers (CHW) found?

In the whole of KwaZulu-Natal, in rural and urban areas. There are presently over 4000 Community Health Workers in the province, and there is an additional 1000 new posts in the financial year 2004/05. It is envisaged that there will be 1000 new posts each year to improve the coverage, as some areas do not have Community Health Workers, yet they are in need.

What training does the CHW recieve?

A Community Health Worker is multiskilled in her/his training to be able to manage problems in their field when rendering services. The bases of training include among others, the following modules:

Being a Community Health Worker
Situational Analysis
Environmental Health Care
The District Health System
Primary Health Care Concept
Acute and Chronic Diseases and their management at home.
T.B and DOTS
Body systems
HIV and AIDS including counselling and support
Health Education and Promotion
Maternal and Child Health
Integrated management of childhood illnesses
Prevention of Mother to Child Transmission (PMTCT)
ARVT
Disabilities
Infectious Diseases
Community Development

The Community Health Workers receive in-service education on a monthly basis on their aspects of health e.g. alcoholism and drug abuse in communities, rendered by specialists e.g. Alcohol Anonymous.

Status Quo of Community Health Workers in KZN

There are 2 different categories of Community Health Workers at present i.e. those employed prior to 1994 and those employed after 1994 after the restructuring of Health Services.

- 4010 available and filled posts
- contracted to NGO’s as at the end of January 2005 - 2602
- Ex-kwaZulu Government CHW’s – 1519 posts available.

Criteria for selection

Minimum for contracted is Grade 10 (standard 8), for non-contracted is non specific and variable.
Have a reside in the area of service
Selected by the Local Community
Undergoes training for multi-skilling x12 months inclusive of practical.
The selection process is guided and based on the existing policy
Has job description , basic minimum conditions of employment
Non-contracted were volunteers who underwent multi-skilling training before 1994.
No criteria were set for volunteers.

Supervision

By Community Based Supervisor for time sheet signing.
By CHF for mentor and support on training
By NGO’s for implementation after training
Has a set of households to visit monthly
Sport check and supervision by contracted NPO’s.
NB: This applies to contracted CHW’s and for non-contracted CHW’s supervision excludes NGO’s.

What is the core business of a community health worker?

Health Promotion and Education at household level.
Refer to relevant Departments those needing to.
Identify areas of potential danger or hazard ad report to relevant departments.
Initiate and support community based development projects
Liaison between community and Department of Health
Advocacy and Marketing for Department of Health at community level.
Community mobilization against diseases and ill health through awareness campaigns, health promotional material, word of mouth, role modelling, etc.
Counselling, support, passionate caring, stress relief etc.
DOTS – directly supervised treatment support
Home Based Care
Screening of Health related cards for compliance or default
Assesses health status of all family members and give advises.
Weighs infants and babies and record in the Road to Health Card.
Provide PMTCT support at household level.

How do Community Health Workers Differ from Home Based Care Workers

Community Health Worker	Home Based Care Worker
They are employed	They are volunteers
They are trained and multiskilled for 12 months	They are sometimes trained for 10 days sometimes not trained
They have a job description	They sometime don’t have a job description if not working under NGO’s
They are allocated between 50 and 100 homestead to work in	They may have or may not have a household allocated
They have a selection process based on a consultative policy	They volunteer services
They are on contract or employed with a stipend constantly	Sometime on a stipend when employed
They render comprehensive services within their scope of practice	They render home based care and other services based on what they are trained in
Their training curriculum is at NQF Level 4	Their training is at the Level of NQF 1 – 2
They are sometimes supplied with working kits	They are mostly supplied with HBC kits

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