Okafor Uchenna Benedine, Obasanjo Iyabo, Goon Daniel Ter
Department of Nursing Science, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha, 5117, South Africa.
Faculty of Health Sciences, University of Maryland, Baltimore, MD, USA.
Risk Manag Healthc Policy. 2025 Jul 12;18:2413-2422. doi: 10.2147/RMHP.S488249. eCollection 2025.
One of the challenges CHWs face in their profession is their underrepresentation in program advancement. Despite the importance of community health workers as an adjunct health workforce providing crucial healthcare services to the rural, marginalized, and underserved populations, their opinions on strengthening the CHW program remain understudied in certain geographical contexts. Consequently, this study explores the opinions of community health workers regarding the support systems desirable for their effective delivery of healthcare support services in the Buffalo Municipality City, Eastern Cape Province of South Africa.
In-depth individual, semi-structured interviews (n=10) as well as focus groups interviews (n=13) were conducted with 23 community health workers, using an audio recorder with their permission to record the interviews. Content and thematic data analysis was applied.
The CHWs made several suggestions to assist them serve the community better and improve the community health program. These include provision of transportation, constant training workshops to enhance and maintain their skills and knowledge, support to improve communication with clients, provision of work identifiers to earn community's recognition, respect, and trust, and improvement in human and material resources to mitigate the overwhelming workload. In addition, they emphasised the need to address job insecurity by offering them with permanent, salaried positions, as well as the safety concerns posed by violent crimes in the communities they served.
The findings of this study have implications for improving the practise of CHW programs, policies, and future research recommendations, emphasising the need to take into considerations, the suggestions of the CHWs in improving the CHW program to enable them to provide effective and optimal healthcare support services to clients and the community. We advocated for the integration of community health workers into the larger healthcare system.
社区卫生工作者在其职业中面临的挑战之一是他们在项目推进中的代表性不足。尽管社区卫生工作者作为辅助卫生人力，为农村、边缘化和服务不足的人群提供关键的医疗服务非常重要，但在某些地理环境中，他们对加强社区卫生工作者项目的意见仍未得到充分研究。因此，本研究探讨了南非东开普省布法罗市社区卫生工作者对有效提供医疗支持服务所需支持系统的看法。
对23名社区卫生工作者进行了深入的个人半结构化访谈（n = 10）以及焦点小组访谈（n = 13），经他们许可使用录音机记录访谈内容。采用了内容和主题数据分析方法。
社区卫生工作者提出了多项建议，以帮助他们更好地服务社区并改善社区卫生项目。这些建议包括提供交通、定期举办培训讲习班以提高和保持他们的技能与知识、支持改善与客户的沟通、提供工作标识以赢得社区的认可、尊重和信任，以及增加人力和物力资源以减轻繁重的工作量。此外，他们强调需要通过为他们提供长期有薪职位来解决工作不稳定问题，以及解决他们在服务社区中面临的暴力犯罪带来的安全问题。
本研究的结果对改进社区卫生工作者项目的实践、政策及未来研究建议具有启示意义，强调在改进社区卫生工作者项目时需要考虑社区卫生工作者的建议，以使他们能够为客户和社区提供有效和最佳的医疗支持服务。我们主张将社区卫生工作者纳入更大的医疗体系。
