Perceptions of community health workers on their training, teamwork and practice: a cross-sectional study in Tshwane district, Gauteng, South Africa.

Background: In 2011, South Africa established ward-based outreach teams (WBOTs) comprising Community Health Workers as part of strategies to strengthen primary healthcare. The new community health workers (CHWs) lacked experience of the programme. This study aimed at assessing perceptions of community health workers on their training, teamwork and practice. Methods: This was a cross-sectional study conducted among CHWs in the seven regions of Tshwane health district between October and November 2015. Data were collected from 431 CHWs in eight Community Health Centres and 11 clinics using a pre-tested, self-administered questionnaire. Outcome measures were CHWs' perceptions on training, teamwork and practice regarding WBOT programme. Results: A total of 431 CHWs formed the study sample. Participants had a mean age of 36 years (SD +/- 9.46). The majority (88.2%) were female. Some 77% had completed secondary school. Overall, most CHWs perceived their training (86.4%), teamwork (87.6%) and practices (67.7%) to be good (p = 0.001). The majority were able to provide efficient health care despite the challenges experienced, which were lack of equipment, walking long distances, and safety on the streets and in households with patients who had mental health problems among others. Fisher's exact test showed a significant association between training and work challenges (p = 0.006). Conclusion: The study findings showed that most CHWs had good perceptions regarding their training, teamwork and practice. Several concerns raised by CHWs suggest the need for stakeholders to ensure availability of resources for optimal functioning of CHWs.