Community Health Workers

CHW’s are at the very heart of South Africa’s primary health care system, forming a crucial link between communities and health facilities. They are often the first and most consistent point of contact for individuals seeking care, especially in underserved areas. Yet, despite their indispensable role, CHWs remain largely unrecognised and unsupported within the formal health and labour systems. 

CHW’s are critical to health promotion, disease prevention, early diagnosis and referral, and helping people to stay on treatment and stay healthy. Since CHWs live in the same communities they serve, they experience the same social, economic and environmental living conditions. They understand the lived experiences, the challenges and strengths of the communities they live in and serve.

PHMSA works closely together with the South African Care Workers Forum (SACWF) to achieve its mission. The SACWF was formed to champion the rights and recognition of community health care workers (CHWs) is South Africa.

While initially PHM SA supported the establishment of the SACWF with training including the Right to Health, Self-organising, the Role of CHW’s in the Health System, currently our collaboration is focussing on supporting the legal fight for formal recognition of CHWs in the form of permanent employment within the health system. Together with 2 other organisations (Khanya College and Sinani), PHM SA works with Lawyers for Human Rights and supports national mobilising activities to achieve this goal.

PHM programs in support of CHW:

SAPHU supporting CHW self-organising

SAPHU’s between 2014 and 2016 

SAPHU 2019 in Durban

500 CWH’s mobilised for permanent employment 

The South African Care Workers Forum (SACWF)

Rooted in the vision of “nothing about us without us,” 

The SACWF was formed to 

• advocate for the formal recognition of CHWs as workers, in line with South Africa’s Constitution and labour laws. 
• improve working conditions for CHWs through advocacy for fair wages, psychosocial support, decent health care access, and professional training opportunities.
• emphasize gender equality and the empowerment of women in both the workplace and the communities they serve. 

By facilitating leadership development at area, provincial, and national levels, SACWF equips CHWs to organise collectively, voice their concerns, and influence the policies that shape their working lives.

SACWF’s work is deeply grounded in building the collective power of CHWs. It develops informed and active leadership within the CHW community, strengthens local and provincial organising structures, and promotes solidarity through information-sharing and collective advocacy. Central to its strategy is the capacitation of care workers—not only to achieve formal labour recognition, but also to address the personal and environmental stressors they face. Through ongoing empowerment initiatives, SACWF enables CHWs to become agents of change, both within the health system and in their broader communities.

The importance of SACWF’s mission cannot be overstated. 

The Alma-Ata Declaration (1987) affirmed that primary health care—delivered in and with communities—is the key to achieving “Health for All.” CHWs are the human infrastructure of this approach. They embody the principles of community participation, equity, and universal access that the Alma-Ata Declaration and subsequent global health frameworks promote. Without them, these goals remain out of reach.

For PHM-SA, supporting SACWF is not just a matter of solidarity—it is a strategic imperative. CHWs are the cornerstone of a people-centred health system. Their empowerment strengthens the entire health system’s ability to deliver equitable, accessible, and culturally appropriate care. Supporting SACWF means amplifying the voice of those who serve on the frontlines of health every day, and who—if recognised and supported—can help realise the right to health for all South Africans.

Community Health Workers