Health and Wellness
Whether her Department has any plans for the absorption of community health workers into the government service; if not, why not; if so, (a) what do the plans entail, (b) how many community health workers will be absorbed into the government service and (c) what is the expected time frame for this process?
The Western Cape Department of Health and Wellness (WCDHW) recognises the important role that community health workers (CHWs) play as part of a broader, team-based primary healthcare approach, supporting prevention, early identification, linkage to care, and continuity of support between households and health facilities.
A Labour Court of South Africa (Johannesburg) ruling of January 2025 requiring the absorption of CHWs into government does not apply to the Western Cape, it only applies the to the other eight provinces where CHWs were previously added to Persal. This is not the case in the Western Cape which has a different CHW model. In the Western Cape, NPOs are contracted to provide CHW services.
(a) The WCDHW therefore does not intend to absorb all CHWs into the formal government establishment since CHW services are currently engaged primarily through contracted non-profit organisations (NPOs), which enables flexibility, community responsiveness, and scalability of services within a constrained fiscal environment. We believe that this approach serves to not only strengthen community health, but also to strengthen and develop a vibrant and resilient NPO and NGO sector, a critical civil society partner in the delivery of community-oriented healthcare.
The WCDHW continues to strengthen and formalise the CHW platform through:
- Standardised training, supervision, and integration
- Alignment with community-oriented primary care (COPC) principles,
- Improved governance, monitoring, and support mechanisms for NPO partners, and
- The NPO Service package, which defines the minimum provincial scope of services to be delivered by CHWs, which is reviewed annually and may be updated in line with departmental priorities.
(b) N/A
(c) N/A
The WCDHW remains committed to strengthening the CHW platform as a critical enabler of accessible, person-centred care, while ensuring that any future reforms are responsible, sustainable, and in the best interest of the health system and the communities it serves.
