Among South Africa’s everyday heroes are community health workers, a largely unrecognised but critical workforce that takes primary healthcare to the homes of vulnerable families.
More than 60 000 community health workers — themselves mostly poor black women afflicted by the same problems as the people they serve — are adherence counsellors, health promoters and home-based carers. Through their work the government has been able to bring conditions such as HIV and tuberculosis under control.
In countries such as Brazil and Peru, community health workers have played a critical role in helping to bring down high levels of stunting, a condition that results from malnutrition and also affects a child’s brain development, which has consequences for their education and future employment prospects.
Community health workers visit homes of pregnant women and mothers with babies in the first 1 000 days from conception to a child’s second birthday. This is a period when vulnerability to stunting is at its highest. Community health workers help the women with the physical and psychological demands of pregnancy and the emotional and nutritional needs of a baby.
In addition, community health workers support mothers in exclusively breastfeeding for six months and advise mothers on the timely introduction of nutritious foods, both of which are critical for the prevention of stunting.
In South Africa one in four children are stunted, which means that the prospects for a quarter of the next generation of finishing school, securing employment and living a healthy and fulfilled life are short-changed before they have had an opportunity to enter the race.
The community health workers could play a significant role in turning the tide on stunting in South Africa if adequately supported with the resources, training, coaching, mentoring and dignified employment conditions they need to do their work optimally.
In Limpopo, in collaboration with the provincial department of health, there are early signs of progress through a partnership that supports and equips community health workers in the Mopani subdistrict of the Greater Letaba area. Community health workers are provided with the tools and support they need to protect children from stunting.
It is heartening that at a national level there is increasing recognition of the role community health workers can play in helping to improve our country’s maternal and child health outcomes.
This shift needs to be underpinned by the resources, equipment, mentorship and coaching necessary to translate progressive policies into effective interventions that can stunt a silent epidemic.
When Finance Minister Tito Mboweni announced earlier this year that community health worker wages would be increased to R3 500, it was welcome news and showed that the government not only acknowledged their work, but was ready to deepen its support.
We hope this is just the beginning for this workforce, who for too long has gone undervalued and has worked tirelessly under precarious employment conditions. It is about time that health workers were recognised and celebrated for the difficult work they do.