Community Health Workers: Bridging the Gap in Rural Healthcare
In the remote rural Eastern Cape of South Africa, access to healthcare is a challenge. With few clinics and treacherous roads, the residents rely on the quiet resilience of community health workers, known as ooNomakhaya in isiXhosa, which translates to “home-carers.”
One such nomakhaya is Asonwabisa Sipatana, a 30-year-old whose work is deeply rooted in her family’s legacy of healing. Her grandmother, Nozolile Zintoyinto, a respected sangoma in the village of Nqileni, has passed down the calling of healing to Asonwabisa. Zintoyinto, at 93 years old, acknowledges the importance of her granddaughter’s work in bringing comfort and peace to those in need.
Asonwabisa, along with 19 other nomakhayas employed by the Bulungula Incubator, plays a crucial role in delivering healthcare at home. These community health workers conduct health screenings, provide maternal and child health support, monitor early childhood development, and raise awareness about health emergencies such as disease outbreaks. Their proximity, professional knowledge, and cultural insight make them indispensable in hard-to-reach areas where trust and familiarity are essential.
The barriers to healthcare in rural areas are significant. Clinics are often hours away, and the experience can be overwhelming for patients due to overburdened staff and long queues. In poor communities, systemic inequities can lead to delayed care and poor adherence to treatment plans.
Nomakhayas stand out for their unique approach to healthcare. As members of the communities they serve, they build trust and familiarity with patients. By visiting patients in their homes, they can understand the broader context of their lives and provide personalized care. This approach mirrors traditional healing practices that have been part of rural communities for generations.
One success story highlights the impact of nomakhayas in saving lives. A one-year-old child, identified as HIV positive during a routine home visit, was connected to lifesaving medication through the intervention of a nomakhaya. The child’s recovery was made possible by the trust and confidentiality maintained by the community health worker.
As South Africa prepares to roll out the National Health Insurance (NHI), the success of nomakhayas offers valuable lessons. Recognizing the unique value of community health workers, investing in their future, and incorporating cultural understanding into healthcare delivery are crucial steps towards universal health coverage.
Instead of creating entirely new systems, health services can learn from the models that are already working in rural communities. Nomakhayas bridge the gap between traditional and modern healthcare, making a meaningful impact in the lives of those they serve.
Sigrid Kite-Banks, the strategic communications manager at Bulungula Incubator, emphasizes the importance of community health workers in delivering healthcare to rural areas. The NGO’s team of nomakhayas serves the Xhora Mouth Administrative Area in the Eastern Cape, embodying the spirit of compassion and dedication in their work.
This article was produced by the Bhekisisa Centre for Health Journalism, highlighting the critical role of community health workers in bridging the gap in rural healthcare.
