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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.