Scaling community-based services in Gauteng, South Africa: A comparison of three workforce-planning scenarios

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Scaling community-based services in Gauteng, South Africa: A comparison of three workforce-planning scenarios
 
Creator Bennett, Rod Marcus, Tessa S. Abbott, Geoff Hugo, Jannie F
 
Subject Family Medicine; Primary Health Care Modelling; Community Oriented Primary Care; Community Health Workers; Community Based Services; Intergrated District Health
Description Background: The introduction of community-based services through community health workers is an opportunity to redefine the approach and practice of primary health care. Based on bestpractice community oriented primary care (COPC), a COPC planning toolkit has been developed to model the creation of a community-based tier in an integrated district health system.Aim: The article describes the methodologies and assumptions used to determine workforce numbers and service costs for three scenarios and applies them to the poorest 60% of the population in Gauteng, South Africa.Setting: The study derives from a Gauteng Department of Health, Family Medicine (University of Pretoria) partnership to support information and communication technology (ICT)-enabled COPC through community-based health teams (termed as ward-based outreach teams).Methods: The modelling uses national census age, gender and income data at small area level, provincial facility and national burden of disease data. Service calculations take into account multidimensional poverty, demand-adjusted burden of disease and available work time adjusted for conditions of employment and geography.Results: Assuming the use of ICT for each, a health workforce of 14 819, 17 925 and 7303 is required per scenario (current practice, national norms and full-time employed COPC), respectively. Total service costs for the respective scenarios range from R1.1 billion, through R947 million to R783 million.Conclusion: Modelling shows that delivering ICT-enabled COPC with full-time employees is the optimal scenario. It requires the smallest workforce, is the most economical, even when individual community health worker costs of employment are twice those of current practice, and is systemically the most effective.
 
Publisher AOSIS
 
Contributor WHO I-Tech SA.
Date 2018-05-31
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — modelling
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/phcfm.v10i1.1748
 
Source African Journal of Primary Health Care & Family Medicine; Vol 10, No 1 (2018); 7 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/1748/2617 https://phcfm.org/index.php/phcfm/article/view/1748/2616 https://phcfm.org/index.php/phcfm/article/view/1748/2618 https://phcfm.org/index.php/phcfm/article/view/1748/2608
 
Coverage Gauteng; South Africa 2017 community health workers; poorest 60% of the population
Rights Copyright (c) 2018 Rod Bennett, Tessa S. Marcus, Geoff Abbott, Jannie F Hugo https://creativecommons.org/licenses/by/4.0
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