Improving Community Health Program: Perspective of Community Health Workers in the Eastern Cape, South Africa

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.