Gauteng Department of Health, School of Health Systems and Public Health, University of Pretoria, and School of Public Health, University of Witwatersrand, Gauteng, South Africa.
School of Health Systems and Public Health, University of Pretoria and Colleges of Medicine, Gauteng, South Africa.
Hum Resour Health. 2021 Feb 18;19(1):22. doi: 10.1186/s12960-021-00565-4.
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.
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.
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.
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, non-communicable diseases), as well as social services. These teams provided comprehensive care in a large-scale urban setting and can improve access to care.
社区卫生工作者团队是确保弱势社区获得医疗服务的潜在变革者。他们是谁？他们实际做什么？他们能帮助南非实现全民健康覆盖吗？作为卫生服务的主动部门，社区卫生工作者团队为家庭和社区提供健康教育、早期筛查、追踪和转介一系列卫生和社会服务。除了针对艾滋病毒和结核病等特定疾病的活动外，关于这些团队提供的家庭服务，本地或全球几乎没有证据。本文旨在填补这一空白。
对南非埃库鲁莱尼卫生区社区卫生工作者团队活动的描述性二次数据分析，涵盖了约 28 万户家庭，共 100 万人。
研究结果表明，这些团队中的社区卫生工作者为孕妇和五岁以下儿童提供早期筛查和转介服务。他们向家庭分发避孕套和慢性病药物。他们对高血压、糖尿病、艾滋病毒和结核病进行筛查和转介。团队还进行了逾期和接触者追踪，其中大部分是艾滋病毒和结核病患者。提供的社会心理支持形式是获得社会补助金、获得儿童和性别暴力保护服务、食品包和其他服务。
社区卫生工作者是这些团队的核心，除了一般的健康教育外，他们还在南非家庭和贫困社区提供多项卫生和社会心理服务。研究中所研究的团队提供了一系列针对多种健康状况（母婴相关、艾滋病毒和结核病、非传染性疾病）以及社会服务的活动。这些团队在大规模城市环境中提供全面护理，可以改善获得医疗服务的机会。
