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Table 1 Policy recommendations for community based services in Healthcare 2030

From: The challenges of reshaping disease specific and care oriented community based services towards comprehensive goals: a situation appraisal in the Western Cape Province, South Africa

Policy dimension

Policy recommendation

Roles

Comprehensive orientation including preventive, promotive, care and rehabilitation;

Community based action on determinants of health as part of a broader inter-sectoral focus on wellness;

Outcome oriented approach focused on major causes of ill-health in the province: HIV/AIDS and TB, chronic non communicable diseases, violence and injury, mental health, maternal (parent) infant and child health, early childhood development;

Target population

Population based model in which teams are responsible for the health of a defined population (electoral wards in urban/metro areas, sub-district rural areas);

Proactive approach to all households;

Links to health care system

Integral part of public primary health care system, supervised and supported by facility based staff;

Team structure and ratios

Each CHW works 8 hours a day and responsible for 270 households;

Team of 10 CHWs to be supported by one Clinical Nurse Practitioner;

One rehabilitation care worker per 8 CHWs;

CHW training

Core roles and training standardised, based on a nationally accredited curriculum;

M&E system

Standardised M&E systems reporting on key indicators;

Use of mHealth strategies for M&E;

Value system

Person/patient centred;

Community embeddedness: stable, long term relationships with households which build empathy and trust.