Abstract #172  -  Angels without wings: The role of community based health workers in the arrangement of care for PLWA and OVC
Authors:   Presenting Author:   Ms Corrie du Preez - University of Zululand
Additional Authors:
Aim: The Uthungulu district, like the majority of districts in the KwaZulu-Natal province of South Africa, is known for its high HIV prevalence (39.1%). With limited access to anti retroviral treatment (ART) many people are suffering from AIDS-related illnesses and many children are orphaned due to AIDS-attributed deaths. There is a gap between institutional care and the capacity of households to absorb the additional burden of care for people living with AIDS (PLWA) and orphans and vulnerable children (OVC). Community based health workers can play a vital role in filling this gap, but their role in the arrangement of care for PLWA and OVC is underreported and poorly understood. The aim of this paper is to provide a comprehensive description of the work done by a group of community based health workers in Mbonambi in the Uthungulu district. This paper elaborates on their important role in complementing household arrangement of care for PLWA and OVC and explores their role as liaison between individuals, households, and institutions charged with the provision of care and support.
Method / Issue: In-depth interviews using a semi-structured interview schedule were conducted with 11 community based health workers, eight paid community health workers (CHW) and three volunteer home based caregivers (HBC). Five were also accompanied on several home visits to observe care-related activities and interaction with PLWA, OVC, household members and other relevant persons. Attendance of health worker and support group meetings provided an opportunity for collection of additional information. Qualitative data analysis was done manually by converting raw field notes into write-ups. Themes were identified and data from interviews and observations integrated.
Results / Comments: Health workers were all female and ages ranged between 41 and 67 years of age. The majority were working as volunteers since the early 1990s with eight of them identified, trained, formally employed and paid by a local industry since 1997. Paid CHWs received two years of training with variation in the duration of training of volunteers (HBCs). Both groups are supervised by the local public health clinic and regularly receive additional training. Home visits of PLWA and OVC makes up the bulk of their work and an average of 16 homesteads are visited up to three times per month. Visits include a variety of activities ranging from assessing the health and living conditions to assisting with domestic work and nursing care. The majority of health workers also visit schools to identify and monitor OVC and to educate learners about HIV/AIDS. Some of them also host support groups and are involved in AIDS-related community projects.
Discussion: Despite limited material resources to their disposal and problems such as stigma, CHWs and HBCs are dedicated and well organised in the way they conduct their work, but many PLWA and OVC in need are not yet reached. The involvement of a local industry in this study can serve as a model for business and industry on how they can participate in the community response to HIV/AIDS.
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