Community Health Workers’ Palliative Care Learning Needs and Training: Results from a Partnership between a US University and a Rural Community Organization in Mpumalanga Province, South Africa

2016 ◽  
Vol 27 (2) ◽  
pp. 440-449 ◽  
Author(s):  
Cathy Campbell ◽  
Marianne Baernholdt
Keyword(s):  
South Africa ◽  
Palliative Care ◽  
Community Health ◽  
Rural Community ◽  
Health Workers ◽  
Community Organization ◽  
Learning Needs ◽  
Mpumalanga Province ◽  
And Training ◽  
Us University

scholarly journals Post-trial perceptions of a symptom-based TB screening intervention in South Africa: implementation insights and future directions for TB preventive healthcare services

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicole Salazar-Austin ◽  
Minja Milovanovic ◽  
Nora S. West ◽  
Molefi Tladi ◽  
Grace Link Barnes ◽  
...  
Keyword(s):  
South Africa ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Implementation Strategies ◽  
Healthcare Services ◽  
Preventive Therapy ◽  
Provider Perceptions ◽  
Symptom Screening ◽  
Study Implementation

Abstract Background Tuberculosis is a top-10 cause of under-5 mortality, despite policies promoting tuberculosis preventive therapy (TPT). We previously conducted a cluster randomized trial to evaluate the effectiveness of symptom-based versus tuberculin skin-based screening on child TPT uptake. Symptom-based screening did not improve TPT uptake and nearly two-thirds of child contacts were not identified or not linked to care. Here we qualitatively explored healthcare provider perceptions of factors that impacted TPT uptake among child contacts. Methods Sixteen in-depth interviews were conducted with key informants including healthcare providers and administrators who participated in the trial in Matlosana, South Africa. The participants’ experience with symptom-based screening, study implementation strategies, and ongoing challenges with child contact identification and linkage to care were explored. Interviews were systematically coded and thematic content analysis was conducted. Results Participants’ had mixed opinions about symptom-based screening and high acceptability of the study implementation strategies. A key barrier to optimizing child contact screening and evaluation was the supervision and training of community health workers. Conclusions Symptom screening is a simple and effective strategy to evaluate child contacts, but additional pediatric training is needed to provide comfort with decision making. New clinic-based child contact files were highly valued by providers who continued to use them after trial completion. Future interventions to improve child contact management will need to address how to best utilize community health workers in identifying and linking child contacts to care. Trial registration The results presented here were from research related to NCT03074799, retrospectively registered on 9 March 2017.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

scholarly journals Fidelity of HIV programme implementation by community health workers in rural Mopani district, South Africa: a community survey

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Nireshni Naidoo ◽  
Jean P. Railton ◽  
Sellina N. Khosa ◽  
Nthabiseng Matlakala ◽  
Gert Marincowitz ◽  
...  
Keyword(s):  
South Africa ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Survey ◽  
Programme Implementation

scholarly journals Compensation Models for Community Health Workers: Comparison of Legal Frameworks across Five Countries

2020 ◽  
Author(s):  
Madeleine Ballard ◽  
Carey Westgate ◽  
Rebecca Alban ◽  
Nandini Choudhury ◽  
Rehan Adamjee ◽  
...  
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Legal Framework ◽  
Law Firms ◽  
Advantages And Disadvantages ◽  
Compensation Mechanisms ◽  
Legal Frameworks

Abstract Background Despite the life-saving work they perform, community health workers (CHWs) have long been subject to global debate about their remuneration. There is now, however, an emerging consensus that CHWs should be paid. As the discussion evolves from whether to financially remunerate CHWs to how to do so, there is an urgent need to better understand the types of CHW payment models and their implications. Methods This study examines the legal framework on CHW compensation in five countries: Brazil, Ghana, Nigeria, Rwanda, and South Africa. In order to map the characteristics of each approach, a standardized questionnaire was developed and targeted at local law firms. The questionnaire covered legal structures and requirements for compensation of CHWs, CHW compensation mechanisms, CHW legal protections and benefits, and alignment of national CHW policies with global guidelines. Results The five countries profiled represent possible archetypes for CHW compensation: Brazil (public), Ghana (volunteer-based), Nigeria (private), Rwanda (cooperatives with performance based incentives) and South Africa (hybrid public/private). Advantages and disadvantages of each model with respect to (i) CHWs, in terms of financial protection, and (ii) the public sector, in terms of ease of implementation, are outlined. Conclusions While a strong legal framework does not necessarily translate into high-quality implementation, it is the first necessary step. While certain approaches to CHW compensation - particularly public-sector or hybrid models with public sector wage floors - best institutionalize recommended CHW protections, political will and long-term financing often remain obstacles. Removing ecosystem barriers - such as multilateral and bilateral restrictions on the payment of salaries - can help governments institutionalize CHW payment.

scholarly journals A Randomized Control Trial to Test Effect of Cash Incentives and Training on Active Casefinding for Tuberculosis among Community Health Workers in Nigeria

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1154
Author(s):  
Christie Akwaowo ◽  
Victor Umoh ◽  
Idongesit Umoh ◽  
Eno Usoroh ◽  
Olugbemi Motilewa ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Case Finding ◽  
P Value ◽  
Case Detection ◽  
High Burden ◽  
Cash Incentives ◽  
Case Notification ◽  
And Training

Background: Case detection for Tuberculosis remains low in high burden communities. Community Health Workers (CHWs) are the first point of contact for many Nigerians in the rural areas and have been found useful in active case finding. This study assessed the effect of cash incentives and training on tuberculosis case detection by CHWs in six Local Government Areas in Nigeria. Materials and Methods: A randomised control trial was conducted in three PHC clusters. The intervention Arm (A) received cash incentives for every presumptive case referred. The Training Arm(B) had no cash incentives and the control had neither training nor cash incentives. Case notification rates from the TB program were used to assess the effect of cash incentives on TB case finding. Data was analyzed using Graph Pad Prism. Descriptive data was presented in tables and bivariate data was analyzed using chi square. Mean increases in case notification rates was calculated Statistical significance was set as P=0.05. Results: The intervention identified 394 presumptive TB cases, contributing 30.3% of all presumptive cases notified in the LGAs. Findings also showed an increase of 14.4% (ꭓ2=2.976, P value=0.2258) in case notification rates for the Arm A that received cash incentives alongside training, there was also an increase of 7.4% (ꭓ2= 1.999, P value=0.1575) in Arm B that received Training only. Secondary outcomes indicated a 144.8%(ꭓ2= 4.147, P value=0.1258)  increase in community outreaches conducted in the Arm that were given cash incentives. Conclusion: The study demonstrated an increase in TB control activities of case notification and outreaches among community health workers that received cash incentives and training.  These findings support the use training and cash incentives for CHWs in high burden TB settings to improve TB case detection rates.

Designing Pedagogically-Driven Approaches to Technology-Enhanced Learning for Community Health Workers

2021 ◽  
pp. 87-100
Author(s):  
Shobhana Nagraj
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Educational Interventions ◽  
Training Programme ◽  
Technology Enhanced Learning ◽  
Theoretical Approaches ◽  
Teaching Modality ◽  
Enhanced Learning ◽  
And Training

Technology-enhanced learning (TEL) is well established as a teaching modality. However, there is a lack of evidence for the pedagogical approaches used to design TEL for community health workers (CHWs). This chapter highlights the importance of contextualizing CHW learning within the wider health system. Theoretical approaches to consider when designing a TEL-based education and training programme for CHWs are presented, with practical examples of how these approaches might be most appropriately embedded in the delivery of CHW training. Finally, a framework for the design of pedagogically-grounded TEL-based learning for CHWs is presented, which may be used to help guide the design of TEL-based educational interventions for CHWs.

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