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National Community Health Workers Summit Resolutions, Bloemfontein, 1 March 2019

Community Health Workers (CHWs) in South Africa play an important part in the delivery of health care services to communities. CHWs have been crucial in the health care system through various programmes, including testing and prevention of HIV and TB, treatment adherence as well as health promotion. However, CHWs have lacked recognition and appropriate remuneration for this significant role that they have played. Therefore, CHWs from all provinces have been mobilizing and organizing to work collectively towards improved recognition and better working conditions for CHWs nationwide.

On 28 February – 1 March 2019, 160 CHWs from all 9 provinces in South Africa met in Bloemfontein for a National Community Health Worker Summit. The goal of the summit was to work together to discuss challenges and celebrate the successes of CHW advocacy work and to further CHW aims of attaining permanent employment with appropriate remuneration, acknowledgement, respect and proper working conditions. Key representatives from national and provincial Departments of Health, the Department of Social Development, unions representing CHWs and NGOs employing CHWs were invited to exchange ideas.

The Resolutions adopted at the National Community Health Worker Summit are reproduced below, or  click here to download the pdf version.

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Community Health Workers Summit
on the 01st of March 2019

1 Introduction:

1.1 We, the South African Community Health Workers, 160 of us, representing all nine provinces of South Africa;

1.2 Gathered in Bloemfontein, Free State, from the 28th February to the 01st of March 2019;

1.3 Under the theme:

“In unity we celebrate our milestones to achieving recognition of Community Health Care Work”

1.4 In the presence of:

1.4.1 Six (6) National and Provincial Department of Health Officials;
1.4.2 Nineteen (19) Members of Partner NGOs supporting our work;
1.4.3 Five (5) NGO Representatives employing CHWs in the Western Cape and Northern Cape;
1.4.4 One (1) Member of a Union;
1.4.5 Three (3) Representatives of our Germany Based Partner;

2 Resolve that:

2.1 Solidarity and unity of all CHWs is our own responsibility and we will go all out to strengthening unity and building solidarity amongst all CHWs, nationally. This we will achieve by:

2.1.1 Establishing strong representative forums at Local, District and Provincial levels,
2.1.2 Creating and registering a national structure that has full representation of CHWs from all provinces (2 members per province),
2.1.3 Developing a clear Constitution and campaigns programme,
2.1.4 Working towards ensuring that the National Structure is formalized and can participate in the Bargaining Council to directly represent the interests of CHWs,
2.1.5 Establishing through the National Structure an effective communication channel amongst CHWs using available medias and other tools such as Bavuse,
2.1.6 Establishing an effective communication channel with NDoH for the sole interest of CHWs, and
2.1.7 Fundraising.

3 We call on, and demand of the National Department of Health to:

3.1 Expedite the Permanent Employment of all CHWs,

3.2 Standardize training and implementation of the WBPHCOT policy across all Provinces and the Departments of Health and Social Development,

3.3 Address with immediate effect the stock-out problems currently experienced by some facilities across the country,

3.4 Prioritize the safety and security of CHWs during their field work,

3.5 Only provide or recommend Accredited Training (phase i, ii, iii) for CHWs with clear career paths within the Health System,

3.6 Establish a clear scope of practice and work of CHWs and ensure this is implemented by all provinces,

3.7 Ensure that there are clear Local, District, Provincial and National DoH Platforms to engage with the Department on their issues affecting the workers.

3.8 Ensure that CHWs have:

3.8.1 Access to psycho-social support (trauma counselling),
3.8.2 Access to transportation,
3.8.3 Access to vaccination and prophylaxis treatment for HIV, TB, Hepatitis B,
3.8.4 Access to working equipment and protective aides, and are
3.8.5 Covered by the Occupational Health and Safety Act and this is enforced across the country, and are
3.8.6 Included in the infection control plan.

4 The next Step:

During the last plenary session, it was noted that there are already efforts to unify CHWs. But these are not national, yet, but noted that:

4.1 The South African Community Health Workers Forum is organized and represented in 4 Provinces.

4.2 Gauteng Forum is in Gauteng and is supporting organisation in Mpumalanga, Limpopo, Free State and North West.

4.3 KwaZulu-Natal has a structure (Committee) of CHWs covering the Province.

And the Plenary agreed to use the SACHWF as an organizing Pillar, nationally and further resolved that:

4.4 Each Province will go back home to ensure that there are Local Forums at each locality.

4.5 CHWs from each locality (Municipality) select representatives who will represent them and form District Structures.

4.6 Each Province would form a democratic Provincial Structure.

4.7 Two Members from the Provincial Structure will represent the Province on a National Forum to be convened in June 2019.

Click here for the pdf version of the National CHW Summit Resolutions.

About Estian Smit