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The emergence of community health worker programmes in the late apartheid era in South Africa: An historical analysis

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  • van Ginneken, Nadja
  • Lewin, Simon
  • Berridge, Virginia

Abstract

There is re-emerging interest in community health workers (CHWs) as part of wider policies regarding task-shifting within human resources for health. This paper examines the history of CHW programmes established in South Africa in the later apartheid years (1970s-1994) - a time of innovative initiatives. After 1994, the new democratic government embraced primary healthcare (PHC), however CHW initiatives were not included in their health plan and most of these programmes subsequently collapsed. Since then a wide array of disease-focused CHW projects have emerged, particularly within HIV care. Thirteen oral history interviews and eight witness seminars were conducted in South Africa in April 2008 with founders and CHWs from these earlier programmes. These data were triangulated with written primary sources and analysed using thematic content analysis. The study suggests that 1970s-1990s CHW programmes were seen as innovative, responsive, comprehensive and empowering for staff and communities, a focus which respondents felt was lost within current programmes. The growth of these earlier projects was underpinned by the struggle against apartheid. Respondents felt that the more technical focus of current CHW programmes under-utilise a valuable human resource which previously had a much wider social and health impact. These prior experiences and lessons learned could usefully inform policy-making frameworks for CHWs in South Africa today.

Suggested Citation

  • van Ginneken, Nadja & Lewin, Simon & Berridge, Virginia, 2010. "The emergence of community health worker programmes in the late apartheid era in South Africa: An historical analysis," Social Science & Medicine, Elsevier, vol. 71(6), pages 1110-1118, September.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:6:p:1110-1118
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    References listed on IDEAS

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    1. Mosa Moshabela & Shira Gitomer & Bongiwe Qhibi & Helen Schneider, 2013. "Development of Non-Profit Organisations Providing Health and Social Services in Rural South Africa: A Three-Year Longitudinal Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    2. Laurenzi, Christina A. & Skeen, Sarah & Coetzee, Bronwyne J. & Gordon, Sarah & Notholi, Vuyolwethu & Tomlinson, Mark, 2020. "How do pregnant women and new mothers navigate and respond to challenges in accessing health care? Perspectives from rural South Africa," Social Science & Medicine, Elsevier, vol. 258(C).

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