The Free State health department recently launched a programme to have medication for chronic conditions delivered to elderly patients’ homes. Deliveries will be made by health assistants or community health workers.  These are usually community members who are trained in specific interventions such as health promotion and treatment literacy. 

In addition to delivering medication, health assistants will help monitor patients’ blood pressure and ensure that they take their medication as prescribed.

“I no longer have to wait in long queues at the clinic. Before, I’d have to go to the clinic every two weeks to do tests and be examined. I have applied to be a beneficiary of the new programme where, once a month, I get checked for my blood pressure by nurses at the clinic and once at home, and my medication is delivered to my doorstep,” says 78-year-old Disebo Melato.  

Another beneficiary, 67-year-old Alina Ramothello of Botshabelo-L says the clinic would often be packed and they would go hungry and get exhausted while waiting to be helped.

“But since we can be attended at our homes we are able to be more comfortable.” 

More than just delivering medication

Health assistants do more than just deliver medication. Aletta Maduna, 46, has been doing community health work in Botshabelo for more than a decade. She started off as a volunteer in 2011. She and others were given a contract by the provincial health department early this year. 

“I can do more than what I’m expected to do, for example there are patients who I bathe and give food to when I visit them for medication delivery,” she says.

Other functions of community health workers include HIV counselling and testing.  “We are doing a good job by ensuring that patients take their treatment, we are bathing some and preparing food for some and ensuring that they are ready for their clinic appointment,” says another worker Nelisiwe November, 51.

“We, however, worry about our contracts because it’s only for 12 months. We would be glad if we were permanent workers,” says November.

No job security

The issue of job security for community health workers in the Free State is not new. For years, the department has only employed these workers on a contract basis, citing budget constraints. For example, things came to a head in 2015 with widespread protests by community health workers calling for revised contracts. 

Little has changed for these health workers. 

“We would love to employ the health assistants for a longer time but due to the department’s limited funds we can only offer a one year long contract that is renewable,” says general manager of the primary healthcare facilities in Botshabelo, Daniel More. 

Much to gain

Local health advocacy group Positive Life executive Sindisiwe Nompondo tells Health-e News that the programme will help address HIV and TB treatment relapses.

 “In our recent meeting with the Department of Health and other stakeholders we learnt how many people on HIV and TB treatment were defaulting with their treatment and how community healthcare workers’ programmes would help,” Nompondo says.

Free State health spokesperson Mondli Mvambi  urges the public to help the elderly to register for home services. “People who are bedridden and elderly are currently beneficiaries,” he says.

Mvambi says, because most of the community health workers are women, they are organised into groups for their safety. He could not immediately give figures of how many elderly are currently benefiting from the programme. – Health-e News