TABLE 1.
Pertinent frameworks in relation to the community health worker programme.
| Policy area | NQF | EPWP | NCHWPF | BCEA |
|---|---|---|---|---|
| Date of inception or implementation | 2008 | 2004 | 2004 | 2002 |
| Stipend | Not applicable | CHWs are paid an allowance. R500 for NQF Levels 1, 2, 3 R1000 for NQF Level 4 qualification |
CHWs to receive a stipend. Amount and pay point differs from province to province. | Reported hours that CHWs work indicate that they should be salaried. The amount should be aligned to a national standard. |
| Formal growth pathway | Growth pathway is achieved by completing NQF levels. | The EPWP will up-skill volunteers without Matric to NQF Level 3 and those with Matric up to NQF Level 4. | Volunteers were absorbed into the programme as Generalist CHWs. There is no current growth pathway for CHWs to qualify with a higher rank. | Not applicable. |
| Conditions of employment | Not applicable | Conditions stipulated in job offer and work contract. Work 40 h in a 5 day week, but only earn a stipend that is dependent on the province they work in and not a national standard. | Conditions stipulated in job offer and work contract. Work 40 h in a 5 day week, but only earn a stipend that is dependent on the province they work in and not on a national standard. | National standard is established, to which all employers must adhere to. |
| Formal job title and status | NQF L1: Ancillary Health Worker NQF L2&L3: Community Care Worker NQF L4: Community Health Worker |
Community Health Worker is used as formal title, and individuals are considered as employees. Individuals can volunteer and are unpaid for the programme. | Community Health Worker is the formal title, but there are still other titles such as ‘Community Care Giver’, ‘Home-Based Carer’ and ‘uNompilo’ being used. Individuals can volunteer and can be unpaid for the programme. CHWs are considered employees. |
Not applicable. |
| Supervision | Not applicable | CHW supervisors are allocated a team of CHWs. | An ‘Outreach Nurse’ fulfils both the role of a nurse and CHW supervisor at the CHC. A ward councillor also supervises CHWs. | Not applicable. |
NQF, National Qualifications Framework; EPWP, Expanded Public Works Programme; NCHWPF, National Community Health Worker Policy Framework; BCEA, Basic Conditions of Employment Amendment Act. No. 11 of 2002; CHW, Community Health Worker; CHC, Community Health Centre.