Urban community health workers: selection, training, practice and outcomes

Area of Science:

• Public Health
• Community Health
• Healthcare Delivery

Background:

• The effectiveness and integration of community health workers (CHWs) are subjects of ongoing debate.
• Key considerations for successful CHW programs include community and professional input for needs assessment, selection, training, and accountability.

Purpose of the Study:

• To describe the implementation and outcomes of the Greater Soweto Maternal Child Project, focusing on the role of CHWs.
• To evaluate the services provided and the impact of CHWs in a community setting.

Main Methods:

• Eight trained CHWs provided home-based and neighborhood healthcare services.
• Services included supervised tuberculosis treatment, immunization follow-up, and health education using GOBI FFF and "Facts for Life" guidelines.
• CHWs facilitated referrals and received ongoing training in areas like HIV/AIDS counseling and family planning.

Main Results:

• Over 26 months, CHWs delivered 14,254 health services and conducted 14,501 home visits.
• They managed 8,710 referrals to clinics and other agencies.
• The program demonstrated strong community and institutional support, leading to the redeployment of CHWs into permanent health service roles.

Conclusions:

• The Greater Soweto Maternal Child Project highlights the successful integration and effectiveness of CHWs.
• CHW programs, when properly planned and supported, offer a cost-effective approach to enhancing healthcare services and resource utilization.
• CHWs serve as a vital link between communities and formal healthcare systems.