Outreach services to improve access to health care in South Africa: lessons…

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Global Health Action
Global Health Action is free from all access barriers, allowing for the widest possible global dissemination of your work, leading to more citations. In 2008, the journal was accessed by readers from 110 countries and territories. Published under the Creative Commons.

Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care.Results: The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular contextrelated supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors.

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Outreach services to improve access to health care in South Africa: lessons…