Health Workers Workshop
19 January 2006
Honourable Member of the Mayoral Committee for Health in Ekurhuleni
Metropolitan Council, Councillor N Nciza
Senior Managers of the Gauteng Department of Health
Special guests for today
Community Health Workers
Ladies and gentlemen
It is indeed an honour and privilege for me to stand in front of you as I
did on 21 August 2004. At that time we were handing certificates to the first
group of Community Health Workers who had completed 69 days of intensive
training.
That day was a milestone because we formalised the relationship we have had
with you who have done so much for our communities, mostly under very difficult
circumstances.
The concept of Community Health Workers was part of the vision of the
African National Congress (ANC) during the drafting of the Health Plan. This
Health Plan was drafted in consultation with the World Health Organisation and
UNICEF.
The ANC Health Plan emphasised amongst other things that "Community Health
Workers can play a unique role in promoting health and improving health
services, provided they have effective support and referral structures and
receive an on-going training"
It is clear that, even before we were in government, we already understood
the enormity of the task ahead of us. We knew that, in order to extend
healthcare services to all of our people, community health workers would have
to play a pivotal role.
The concept of community health worker is driven by five imperatives:
* The President's articulation of a people's contract to create work and fight
poverty
* Government's commitment to improve service delivery
* The national human resource and skills development strategies
* The increasing complexity of the burden of diseases and poverty-related
challenges
* The increasing need for health promotion activities, community and home based
care.
The Department of Health sees this cadre of health workers as
community-based generalist health workers. That is why training combines
competencies in health promotion, disease prevention, primary health care and
health-resource networking as well as co-ordination.
We have put systems in place to ensure that this relationship is formalised
and regulated. In pursuit of this vision the Minister of Health launched the
Community Health Worker Programme on 26 February 2004 in Odi Stadium where all
the MECs for Health and a number of Community Health Workers were present.
The National policy framework for Community Health Workers was finalised in
February 2004, while the Gauteng Provincial Policy framework was finalised in
March of the same year. This policy framework acknowledges that there will be
gaps with regard to work loads, uniformity of stipends.
However, management, utilisation and training of Community Health Workers
have been standardised. The gaps I have just referred to also being
addressed.
Community Health Workers are modelled along the lines of the Extended Public
Works Programme, which is aimed at reducing poverty and is co-ordinated by the
Department of Public Works, the Community Development Worker Programme
co-ordinated by the Department of Provincial and Local Government and the
Community Care Worker model within the Department of Social Development.
The main aim of interrogating these models was to ensure that we moved in
the same direction as different government departments.
When this programme was launched in Gauteng there was uncertainty regarding
co-ordination, funding and resources, however the team that was assigned the
task to ensure the success of this programme did commendable work. Their task
was also made easier because most of you are affiliated to Community Based
Organisations.
Even though co-ordination was not smooth initially, the fact that you are
community based and are familiar with the health challenges of your communities
made the task manageable.
Collaboration with Local Government is crucial for the success of this
programme because it is anticipated that it will eventually link up with to the
President's initiative for community development workers who are already making
an impact in many of our municipalities.
The Community Health Workers have a pivotal role in disseminating
information to communities through the Ward Committees. As we are about to vote
in the Local Government Elections that are scheduled for 1 March 2006, I trust
that all of you have registered to vote. When you exercise your right to vote
for a political party of your choice is mindful of voting for those candidates
who will put the interests of local democracy at heart.
The voters roll was closed when the Minister of Provincial Affairs and Local
Government announced the date for elections, however as from 02 March 2006, you
can still update your details in the voters roll. It is important that you
participate in local government elections so that democracy can be entrenched
in local communities.
In the Provincial Health Council, where I sit with the six Members of the
Mayoral Committees for Health in Gauteng municipalities, it was agreed that
MMCs will provide stewardship to this programme. Indeed the role they have
played in ensuring that the programme remains community based is lauded.
Ekurhuleni for example, was the first municipality to launch the Community
Health Worker programme at Ward level. Once Community Health Workers cease to
be community based the whole purpose of the programme will be defeated.
We will begin exploring mechanisms of ensuring that you liaise with Ward
Based Health Committees, Ward Committees, and Ward Councillors. While as
Community Health Workers you are not government employees, your role is valued
because it is an indicator of the peopleâs contract between government and
Community Based Organisations.
This programme does not replace volunteerism but is part and parcel of the
initiative to ensure that people participate in programmes that are meant to
uplift their communities. We are currently funding 263 Community Based
Organisations and Non Profit Organisations (NGOs) at the tune of R71 million,
of which R32 million is dedicated to Home Based Care (HBC) in the current
financial year. Since 2004 we have trained 3379 Community Health Workers. From
the middle of October 2005 until the middle of December 2005 we had trained 362
Community Health Workers. The latter are not yet receiving the stipend because
they have yet to be. We had set ourselves a target of 3000 Community Health
Workers by 2007. We have already exceeded that target.
Dear Community Health Workers, the stipend that is offered to you is not a
salary. It is a gesture on the part of government to say your voluntarism and
efforts are appreciated, hence we encourage those of you who want to advance
themselves to take advantage of the opportunities that are available. Other
career paths exist for Community Health Workers; these include training in
auxiliary nursing. I urge to take up opportunities which are available to
upgrade yourselves. Young people should not be trapped in volunteering
programmes without setting goals for themselves regarding what they want to
achieve in future. Find out how government can assist in helping you to realise
your dreams. The Gauteng Department of Health has set aside R11 million for
bursaries.
There is a shortage of doctors and nurses in the health sector. We shall be
embarking on a programme of recruiting young people to become health
professionals in order to avoid a situation where rich countries neglected this
area and ended up poaching health professionals from poor countries. I support
the suggestion that Community Health Workers should be identifiable by name
tags, as this will also assist in establishing a sense of identity. This will
also assist in also isolating and identifying those who tarnish our image.
Those who tarnish our image should be identified by name instead of
generalisations which paint all health workers with the same brush. When we act
against those who tarnish our image we do so as a health collective. Once more
your contribution is invaluable. I hope these two days will result in
resolutions that will impact on the health of our people. We acknowledge the
work that you, community health workers, have been and continue to do. Most of
you work under very trying conditions. We appreciate that you give hope to
those of our people who are ill and bed-ridden.
We urge you to continue being sources of life and light to our people. We
urge you to continue in your patriotic spirit to bring health care to all of
our people, irrespective of where they live and irrespective of their financial
status. I thank you for your sweat, faith, and for all your commitment.
Together let us continue to work for HEALTH FOR A BETTER LIFE.
I thank you.
Issued by: Department of Health, Gauteng Provincial Government
19 January 2006
Source: Gauteng Provincial Government (http://www.health.gpg.gov.za/)
