The evolving socio-political context of community health worker programmes in South Africa: implications for historical analysis. A commentary on van Ginneken, Lewin and Berridge 'The emergence of community health worker programmes in the late-apartheid era in South Africa: an historical analysis'(2010).

摘要

As of recently in South Africa, 34.9% of medical practitioner and 40 3% of professional nursing posts are vacant in the public health sector (Day & Gray, 2008). Research has indicated that in countries with human resource shortages for health, community health workers (CHWs) can have an important role to play in providing services to the poorest and the most vulnerable communities (Coetzee, Hildebrand et al, 2004; Wouters, van Damme et al, 2009, Zachanah, Teck et al., 2007). After an initial period (1994-1999) of the South African government neglecting CHW programmes, a rapid expansion in HIV/AIDS funding and programmes and renewed interest in child survival have provided the impulse for a significant shift in both international and government thinking towards large-scale deployment of CHWs (Hames, Sanders et al., 2007; Schneider, Hlophe et al., 2008) This resurgence of CHW programmes is matched by a growing body of research investigating the added value of these initiatives to the public health sector (Coetzee et al., 2004; Wouters, van Damme, van Loon, van Rensburg, & Meulemans,