Health care system
Measuring the move towards equity from the site of service delivery: results from the nine provinces
International experience has shown that CHWs can make a valuable contribution to improving basic health status in poor communities. However, the nature of their role in South Africa's Primary Health Care (PHC) system has yet to be defined. The development of CHW programmes will be facilitated by the move towards a district-based health system (DHS). However, the message from other countries is that there must be clarity on the status and role of these front-line health workers for them to achieve their full potential.
With the advent of cheaper drugs, the debates on systems factors affecting HIV/AIDS care are increasingly shifting to questions of how HIV services can be staffed in low-income settings. These debates are informed by a rapidly worsening human resource crisis, which is driven by a brain drain from low-income countries, increasing morbidity and mortality among health workers and rapidly increasing service demands.