The role of community health workers in palliative care in a rural subdistrict in South Africa

Background Effective palliative care is an urgent humanitarian need, particularly in less developed countries, including South Africa (SA). People can be palliated within their communities, motivating the integration of palliative care into primary healthcare systems. While community health workers...

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Bibliographic Details
Published in:	African journal of primary health care & family medicine Vol. 14; no. 1; pp. e1 - e9
Main Authors:	van Heerden, Elza M., Jenkins, Louis S.
Format:	Journal Article
Language:	English
Published:	Cape Town AOSIS 2022 African Online Scientific Information Systems (Pty) Ltd t/a AOSIS AOSIS (Pty) Ltd AOSIS Publishing
Subjects:	Biology Care and treatment Caregivers Community health aides Community health care Community health workers Developed countries Health aspects Health care Health Care Sciences & Services Health promotion HIV Human immunodeficiency virus Interviews Medical personnel Medicine, General & Internal Original Research Pain Pain management Palliative care Palliative treatment Patients Primary health care Qualitative research Registered nurses Roles Rural Rural areas Supervisors Tuberculosis Workers Australia South Africa Sub-Saharan Africa Africa pain palliative care community health workers roles rural
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Summary:	Background Effective palliative care is an urgent humanitarian need, particularly in less developed countries, including South Africa (SA). People can be palliated within their communities, motivating the integration of palliative care into primary healthcare systems. While community health workers (CHWs) play a vital role in health coverage at the primary care level, literature on their roles in palliation is limited.Aim To explore the roles of CHWs in palliative care delivery in a rural subdistrict in SA.Setting This study was conducted in the George subdistrict of the Western Cape province, SA.Methods A descriptive qualitative study explored the perceptions of a wide range of stakeholders (n = 39) of CHWs’ roles in palliative care. Data were collected via semistructured interviews and focus group discussions and analysed thematically.Results Patients experienced severe biopsychosocial symptoms and needed home-based palliation. While CHWs identified and referred patients, their main responsibilities were health promotion and disease prevention. Palliation was primarily a registered nurse’s function. Community health workers were conflicted by their limited ability to deliver basic palliative care to patients.Conclusion While there is a definite need for community-based palliative care, the optimal structure of such a service and the roles of CHWs therein are uncertain. Future research should explore the home-based palliation needs of patients in similar contexts and the service design best suited to address these needs within the primary healthcare domain.Contribution This study illustrates the influence of individual and system-related factors on CHWs’ roles in palliative care. It can inform service design to optimise CHWs’ contribution to palliation within primary health care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2071-2928 2071-2936 2071-2936
DOI:	10.4102/phcfm.v14i1.3657