Publication
Title
The unmet needs and health priorities of the urban poor : generating the evidence base for urban community health worker programmes in South Africa
Author
Abstract
Background. There is a growing interest in involving community health workers (CHWs) into the formal healthcare system in South Africa (SA). Objectives. To generate evidence for defining CHW tasks in urban SA. Methods. A cross-sectional survey of residents of Diepsloot, northern Johannesburg, was performed using geographically weighted random sampling, with home-based health assessment and a questionnaire on sociodemographics, medical history, experience of violence, health-seeking behaviour and perceived health priorities. Results. Between May 2013 and March 2011, 1 230 adults participated. Self-reported medical conditions included hypertension (12%), HIV (10%), diabetes (3%), cancer (1%) and mental illness (1%). Health assessments identified a high prevalence of undiagnosed conditions: hypertension (26%), obesity or overweight (46%), mild to severe depression (23%), HIV infection (5.8%) and tuberculosis (TB) (0.4%). Among women, 18% had unmet family planning needs and 77% had never had a Pap smear. Sexually transmitted infection symptoms were reported by 7% of participants. Physical violence was widespread, with 13% having experienced and 16% witnessing violence in the past year, with women mostly experiencing violence at home and men in the community Participants' top health concerns were crime, safety and violence (19%) and HIV (18%); healthy living/weight control was listed by only 8% of participants. Conclusions. Alignment of CHW roles to unmet health needs and perceived health priorities will be important for optimal impact of CHW programmes in urban communities. Our data suggest that the CHW role should expand from a traditional focus on HIV, TB and maternal health to include non-communicable diseases, healthy lifestyle, and the intersection of violence and health.
Language
English
Source (journal)
SAMJ: South African medical journal / Medical Association of South Africa. - Cape Town
Publication
Cape Town : 2018
ISSN
0256-9574
2078-5135
Volume/pages
108:9(2018), p. 734-740
ISI
000443278500018
Pubmed ID
30182898
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 08.10.2018
Last edited 25.08.2021
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