"She is my teacher and if it was not for her I would be dead": exploration of rural South African community health workers' information, education and communication activities.
Identifieur interne : 002370 ( Ncbi/Merge ); précédent : 002369; suivant : 002371"She is my teacher and if it was not for her I would be dead": exploration of rural South African community health workers' information, education and communication activities.
Auteurs : Rose Zulliger [Afrique du Sud] ; Mosa Moshabela ; Helen SchneiderSource :
- AIDS care [ 1360-0451 ] ; 2014.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (), Agents de santé communautaire, Attitude du personnel soignant, Communication, Counseling directif (), Enquêtes et questionnaires, Femelle, Humains, Infections à VIH (), Infections à VIH (psychologie), Infections à VIH (épidémiologie), Mâle, Pauvreté, Population rurale, Promotion de la santé, Qualité de vie, Recherche qualitative, Recherche sur les services de santé, République d'Afrique du Sud.
- MESH :
- psychologie : Infections à VIH.
- épidémiologie : Infections à VIH.
- Acceptation des soins par le patient, Agents de santé communautaire, Attitude du personnel soignant, Communication, Counseling directif, Enquêtes et questionnaires, Femelle, Humains, Infections à VIH, Mâle, Pauvreté, Population rurale, Promotion de la santé, Qualité de vie, Recherche qualitative, Recherche sur les services de santé, République d'Afrique du Sud.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Attitude of Health Personnel, Communication, Community Health Workers, Directive Counseling (methods), Female, HIV Infections (epidemiology), HIV Infections (psychology), HIV Infections (therapy), Health Promotion, Health Services Research, Humans, Male, Patient Acceptance of Health Care (statistics & numerical data), Poverty, Qualitative Research, Quality of Life, Rural Population, South Africa, Surveys and Questionnaires.
- MESH :
- geographic : South Africa.
- epidemiology : HIV Infections.
- methods : Directive Counseling.
- psychology : HIV Infections.
- statistics & numerical data : Patient Acceptance of Health Care.
- therapy : HIV Infections.
- Attitude of Health Personnel, Communication, Community Health Workers, Female, Health Promotion, Health Services Research, Humans, Male, Poverty, Qualitative Research, Quality of Life, Rural Population, Surveys and Questionnaires.
Abstract
Community health workers (CHWs) are important resources in health systems affected by the HIV/AIDS pandemic. International guidelines on task-shifting recommend that CHWs can provide diverse HIV services, ranging from HIV prevention to counselling patients for lifelong antiretroviral therapy. There is, however, little evidence on the experiences with CHW delivery of these services in Africa. This qualitative study included 102 interviews that explored experiences with information, education and communication (IEC) activities provided by CHWs within rural South Africa. Semi-structured interviews were conducted with CHWs (n = 17), their clients (n = 33) and the primary caregivers of these clients (n = 30), allowing for data source triangulation. Twenty-two follow-up interviews explored emergent themes from preliminary interviews. Despite limited formal education and training, CHWs in this study were significant providers of IEC, including provision of generic health talks and HIV-specific information and facilitation to support clients' entry and maintenance in the formal health system. They often incorporated local knowledge and understanding of illness in their communication. CHWs in this study were able to bridge the lifeworlds of the community and the formal services to expedite access and adherence to local clinics and other services. As mediators between the two worlds, CHWs reinterpreted health information to make it comprehensible in their communities. With growing formalisation of CHW programmes in South Africa and elsewhere, CHWs' important role in health service access, health promotion and health maintenance must be recognised and supported in order to maximise impact.
DOI: 10.1080/09540121.2013.841839
PubMed: 24093798
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pubmed:24093798Le document en format XML
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<front><div type="abstract" xml:lang="en">Community health workers (CHWs) are important resources in health systems affected by the HIV/AIDS pandemic. International guidelines on task-shifting recommend that CHWs can provide diverse HIV services, ranging from HIV prevention to counselling patients for lifelong antiretroviral therapy. There is, however, little evidence on the experiences with CHW delivery of these services in Africa. This qualitative study included 102 interviews that explored experiences with information, education and communication (IEC) activities provided by CHWs within rural South Africa. Semi-structured interviews were conducted with CHWs (n = 17), their clients (n = 33) and the primary caregivers of these clients (n = 30), allowing for data source triangulation. Twenty-two follow-up interviews explored emergent themes from preliminary interviews. Despite limited formal education and training, CHWs in this study were significant providers of IEC, including provision of generic health talks and HIV-specific information and facilitation to support clients' entry and maintenance in the formal health system. They often incorporated local knowledge and understanding of illness in their communication. CHWs in this study were able to bridge the lifeworlds of the community and the formal services to expedite access and adherence to local clinics and other services. As mediators between the two worlds, CHWs reinterpreted health information to make it comprehensible in their communities. With growing formalisation of CHW programmes in South Africa and elsewhere, CHWs' important role in health service access, health promotion and health maintenance must be recognised and supported in order to maximise impact.</div>
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