Roles and Challenges of Community Health Workers Within the Context of National Health Insurance in Vhembe District, South Africa
The provision of universal health coverage is acknowledged as a priority goal for every health care system globally. In South Africa, the National Health Insurance system has been endorsed as a funding model for the provision of universal health coverage for South African citizens. Community health workers have contributed to better universal health coverage outcomes in many countries. A study in India revealed that coverage of health care practices are positively correlated with the knowledge level of community health workers. The difference in training duration among community health workers in South Africa; and in Vhembe district in particular triggered this study, which aimed to assess community health workers knowledge regarding their roles and describe their challenges within the context of National Health Insurance. Qualitative design was used to collect data from 33 participants who formed five focus groups comprised of six to eight members each. Ethical principles of research such as permission, informed consent, voluntary participation and anonymity were observed. Data was analysed using thematic data analysis technique guided by Tesch open coding method. The findings revealed that Community Health Workers had knowledge deficit regarding roles they are expected to play within Ward Based Outreach teams. In addition, Community Health Workers were found to be challenged in many ways including transportation to clients’ homes and poor reception in households. A review of SAQA health promoter unit standards is recommended coupled with mentorship of Community Health Workers by retired nurses to improve knowledge of their roles.
Keywords - Community Health Workers, National Health Insurance, Roles, knowledge, challenges.