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Making ward-based outreach teams an effective component of human immunodeficiency virus programmes in South Africa

Nireshni Naidoo, Jean Railton, Geoffrey Jobson, Nthabiseng Matlakala, Gert Marincowitz, James A. McIntyre, Helen Struthers, Remco P.H. Peters
Southern African Journal of HIV Medicine | Vol 19, No 1 | a778 | DOI: https://doi.org/10.4102/sajhivmed.v19i1.778 | © 2018 Nireshni Naidoo, Jean Railton, Geoffrey Jobson, Nthabiseng Matlakala, Gert Marincowitz, James McIntyre, Helen Struthers, Remco Peters | This work is licensed under CC Attribution 4.0
Submitted: 28 June 2017 | Published: 12 April 2018

About the author(s)

Nireshni Naidoo, Anova Health Institute, Johannesburg & Tzaneen, South Africa and School of Public Health, University of the Witwatersrand, South Africa
Jean Railton, Anova Health Institute, Johannesburg & Tzaneen, South Africa
Geoffrey Jobson, Anova Health Institute, Johannesburg & Tzaneen, South Africa
Nthabiseng Matlakala, Anova Health Institute, Johannesburg & Tzaneen, South Africa
Gert Marincowitz, Mopani DCST, Department of Health, Limpopo Province, South Africa
James A. McIntyre, Anova Health Institute, Johannesburg & Tzaneen, South Africa and School of Public Health & Family Medicine, University of Cape Town, South Africa
Helen Struthers, Anova Health Institute, Johannesburg & Tzaneen, South Africa and Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, South Africa
Remco P.H. Peters, Anova Health Institute, Johannesburg & Tzaneen, South Africa


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Abstract

The implementation of ward-based outreach teams (WBOTs), comprised of community health workers (CHWs), is one of the three interventions of the South African National Department of Health’s (NDoH) Primary Health Care (PHC) Re-engineering strategy for improving health outcomes. CHWs provide a necessary structure to contribute to successful implementation of the human immunodeficiency virus (HIV) programme in four ways: (1) prevention of HIV infection by health education, (2) linkage to care by health education and referrals, (3) adherence support and (4) identification of individuals who are failing treatment. However, CHW programme and HIV programme-specific barriers exist that need to be resolved in order to achieve maximum impact. These include a lack of stakeholder and community support for WBOTs, challenging work and operational environments, a lack of in-depth knowledge and skills, and socio-cultural barriers such as HIV-related stigma. Considering its promising structure, documentation of the WBOT contribution to healthcare overall, and the HIV programme in particular, is urgently warranted to successfully and sustainably incorporate it into the South African healthcare system.

Keywords

Community Health Workers; HIV

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