Community health workers (CHWs) traditionally played a role in supporting the delivery of high priority interventions relating to HIV, TB and maternal and child health. While they are essential for these programmes and improving access to care, there has been significant inconsistency in the management and functioning of the programmes across South Africa. This inconsistency is partly because the role of CHWs is poorly articulated poorly in National or Provincial health policy and thus limited guidance on the qualification requirements,training, employment conditions, the scope of practice or the basic role of CHWS within the health system. In addition, very little attention has been paid to the differences in needs of CHWs’ services between urban and rural areas.
This study was conducted to compare the resource requirements (both financial and human resources) of the CHW component of Ward Based Outreach Teams (WBOTs) between rural, deep-rural and urban/peri-urban communities in order to inform policy. Two districts were selected from with a sample of WBOT teams covering different types of areas. CHWs filled detailed diaries for two consecutive weeks (10 days) reporting on travel time, and activity time per type of activity, recipients visited and conditions covered. This recording resulted in 2,511 entries in uMzinyathi (16% in urban/peri-urban areas) and 4,140 in Sedibeng (68% in urban/peri-urban areas).