Original Research

Community health workers in Lesotho: Experiences of health promotion activities

Thato Seutloali, Lizeka Napoles, Nomonde Bam
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1558 | DOI: https://doi.org/10.4102/phcfm.v10i1.1558 | © 2018 Thato Seutloali, Lizeka Napoles, Nomonde Bam | This work is licensed under CC Attribution 4.0
Submitted: 14 July 2017 | Published: 27 February 2018

About the author(s)

Thato Seutloali, Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, South Africa
Lizeka Napoles, Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, South Africa
Nomonde Bam, Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, South Africa


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Abstract

Background: Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care.
Aim: The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho.
Setting: The study was conducted in four health centres in Berea district, Lesotho.
Methods: A qualitative study was conducted using an interviewer guide translated from English into Sesotho for four CHW focus group discussions, four individual interviews of key informants and four semi-structured interviews with the health centre nurses.
Results: The roles of CHWs in health promotion ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education. Their perceived successes included increased access to health care services and reduced mortality rates. CHW challenges involved their demotivation to carry out their work because of lack of or inconsistent financial incentives and supplies, work overload which compromises quality of their work and limited community involvement.
Conclusion: This study concludes that CHWs are beneficial to health promotion and its various activities. They had a clear understanding of their roles and responsibilities, although they did not fully comprehend that what they were describing was, in fact, health promotion. When it came to advocacy, CHWs did not fully understand it, nor did they consider it as part of their roles, although they acknowledged its importance. Their role of increasing access to health care services by accompanying patients to the facilities has increased considerably because of changes in disease burden. This is affecting their ability to practise other health promotion activities which focus on disease prevention.

Keywords

Health Promotion; Community Health Workers

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