Community health workers essential for SA response

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The Department of Health has announced that it will rely on local healthcare workers to assist in tracking and tracking potential Covid-19 cases, but it does not guarantee how these workers will be protected during the process. I have not.

On Monday, 13 April, Professor Salim Abdool Karim, chairman of the Covid-19 Ministerial Advisory Board, said that tracking and testing in the community as part of an active strategy to control the spread of the virus in the country. Outlined the government’s plan to increase.

Karim and Health Minister Dr. Zweli Mkhize acknowledged the importance of expanding screening and testing where people live, first focusing on high-density, high-risk areas. To this end, there are more than 28,000 community health workers (CHWs) moving from home to home in vulnerable communities. Screen and test people.

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Reliance on CHW to provide medical services is not new. CHW will play a decisive role in responding to Covid-19 in South Africa, just as their intervention is central to the response to tuberculosis and HIV.

This is because they are already part of the community and can help track down those at risk of getting a virus. It will also help with tracking and monitoring even after the lockdown is over.

This bold and decisive action is timely and necessary, but it is unclear how the government intends to protect CHW in the face of the reported lack of personal protective equipment (PPE). .

While CHWs across the country are ready to support efforts to ensure that the virus is contained, they are deeply concerned about their safety. A telephone survey of CHWs in Gauteng, KwaZulu Natal and Western Cape during the week that President Ramafosa announced the lockdown revealed training, availability of PPE for CHWs, and standard operating procedures across and between states. I am worried about inconsistent information.

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Provision of personal protective equipment

CHW is expected to make house-to-house visits to aid in follow-up and is likely to encounter infected individuals (some of which may be asymptomatic), so exposure The risk of. There is also a risk of cross-contamination throughout the households they visit if they are exposed.

Therefore, it is important to make sure that the CHW is equipped with the proper PPE and is carefully trained in its optimal use. To date, the Ministry of Health has not issued specific guidance to CHW regarding the types of protective equipment provided to CHW.

When the Minister of Health gave explanations to the public, and more recently to legislators during parliamentary briefings, he referred to “healthcare workers” who were provided PPE. In his guarantee, he does not publicly refer to CHW as a separate group. Mkhize encourages the use of masks for the general public, even if the mask is made of cloth, but CHW needs a suitable medical mask, who.

For local areas

Responsibility for mobilizing and training CHW lies with the individual states. Nevertheless, the South African constitution emphasizes cooperative governance. Although the state is responsible for its own medical services, it also has important and relevant national and local government responsibilities. National coordination is urgently needed to ensure consistent application of information and protocols and operations.

28,000 CHWs to test and screen are drawn from an existing CHW cohort that forms part of the Word-based Primary Healthcare Outreach Team (WBPHCOT), or a new team is recruited specifically It is not clear if there is. This purpose. This is important for two reasons.

1. If 28,000 people are already in the system and are CHWs performing various tasks, including tracking HIV or TB treatment defaults, what plans do they have to ensure the continuity of their services? Have you been set up? This should be done in a way that does not burden other CHWs. And
2. If 28,000 CHWs are specifically recruited and trained for Covid-19 compliance, how will they be integrated into the system and what support systems will be available at the primary care facility to have the ability to oversee the WBPHCOT program? Will it be provided? Covid-19 Response Team?

To date, there is no standardized protocol for mobilizing and training CHW in relation to the tasks assigned to CHW for Covid-19 compliance. In one state, CHWs are instructed to stay home and do no normal work, while in other states they are expected to report to the facility and receive instructions from a facility manager who is not informed. I will. In another example, CHW is expected to help track people who may have been exposed to the virus without training or protective equipment.

The Minister of Health must issue a directive to the local health sector, which provides a standardized protocol for work related to CHW. These should include CHWs that do not enter the home without suitable protective equipment. You do not need to perform any task that compromises CHW.

Some states have taken steps to get CHW absorbed by the state’s Department of Health, but not all states. In Western Cape, for example, CHW continues to be employed through non-governmental organizations (NGOs). It is not clear what the procedure is for such CHWs to be mobilized for Covid-19, and what the role of NGOs will be.

Urgent steps must be taken to ensure that CHWs hired through registered NGOs receive the same protection afforded to CHWs hired in the country. This also includes a guarantee that if you get a virus, you can get compensation through the Industrial Accident Compensation Act (COIDA). For registration of COIDA CHW, the Minister must direct all health departments.

CHW protection against criminals

Most CHWs are women. They face significant dangers in the process of their work and the government must prioritize their safety. The army was deployed during this period to help police maintain law and order. In some cases, security support may be needed when CHW moves into particularly densely populated areas or areas that may be vulnerable to sexual assault and other criminal activity.

In addition, CHW is at risk of being criticized by community members who are hostile to people with Covid-19 infection. Over the past week, CHW, which was deployed to screen in Nkomagy in Mpumalanga, was attacked and harassed by untrustworthy community members. In response, the municipality[s]He quickly intervened in the police and repeated our message through community radio. There is nothing that healthcare professionals can infect when screening. These people are trained to support the community. There is only a questionnaire that decides you should go for a test. “

This shows that a wide-ranging ongoing education campaign in the community is important to protecting CHW so that it can do its job.

The work of CHW is stressful under normal circumstances. In the light of the risk of increased pandemic poses, they are further exposed to emotional and physical stress. Therefore, it is essential that CHW be provided with psychosocial support after this period.

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As a key component of the healthcare system, and indeed the Covid-19 counterpart, CHW needs to have access to the same support and protection offered to other healthcare providers. While this demand for CHW protection, training, and equipment is in the context of a pandemic, it also highlights existing issues regarding the conditions under which CHW works.

These also include the lack of employment security as they are continually employed on regular contracts and receive a small amount of scholarships (recently struggled for years with standardized rewards). Later, with the agreement of the Negotiation Committee, it increased to 3,500 months).

CHW has also long complained of lack of support from health care facilities, lack of training uniformity, and lack of uniformity of job coverage.

The ball is in government court. What will be done to improve the employment conditions for CHW?

Nontsikelelo Mpulo is the Communications Director for SECTION27. Tendai Mafuma is a legal researcher in SECTION27’s Health Rights Program.

* This article Spotlight – Health journalism for the public good.

Ministry of Health Latest Coronavirus Update (Covid-19)Contains How to prevent NICD. If you develop Symptom Call your doctor or clinic. They will advise you on your next steps. For more information, National Institute of Infectious Diseases website Or call 0800 029 999. Or, send HI to 0600 123 456 on WhatsApp.

During this period, people all over the country have offered support through the Solidarity Fund. Assistance or access to more information https://www.solidarityfund.co.za/.