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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 3, May/June 2017 AFRICA 175
located in an urban township in South Africa, these findings
may not be different in other settings that employ CHWs and
focus on NCDs due to lack of standardised training. Since the
purpose of this training was to empower CHWs with skills to
screen and identify those at risk for CVD, and refer them to the
health facility for treatment, counselling on lifestyle modification
was not included in this training.
Conclusion
Although CHWs could be trained in screening for CVD risk
using a non-invasive risk-screening tool, adequate training time
was needed to enable them to grasp important new concepts.
The language used in both teaching and testing this cadre of
workers should be taken into consideration when measuring
their performance. Inadequate or inappropriate training may
result in health workers failing to do their work as expected.
Sustaining the newly acquired knowledge requires refresher
training.
This project was funded in part with federal funds from the United
States National Heart, Lung, and Blood Institute, National Institutes of
Health, Department of Health and Human Services, under contract no.
HHSN268200900030C. The funding sources played no role in the study
design, data collection, data analysis and interpretation, or the writing of
the report.
References
1. Van Ginneken N, Lewin S, Berridge V. The emergence of community
health worker programmes in the late apartheid era in South Africa: An
historical analysis. Soc Sci Med 2010; 71(6): 1110–1118. doi: 10.1016/j.
socscimed.2010.06.009.
2. Department of Health. Controlling non-communicable diseases through
health system strengthening: Concept paper for discussion at NCD
summit, 2011. Pretoria: National Department of Health.
3. Igumbor EU, Puoane T, Gansky S, Plesh O. Epidemiology of chronic
pain in a peri-urban community in the Eastern Cape Province. J Pain
SA 2011; 6(1): 48
4. Tulchinsky TH, Varavikova EA. What is the ‘New Public Health’? Public
Health Rev 2010; 32: 25–53.
5. Arjun S, Gan K, Carpenter S. Voices from the field: Perspectives
from community health workers on health care delivery in rural
KwaZulu-Natal, South Africa. J Infec Dis 2007; 196: 505–511. DOI:
10.1086/521122/PMID:18181702
6. National Center for Chronic Disease Prevention and Health Promotion
Division for Heart Disease and Stroke Prevention. Addressing chronic
disease through community health workers: A policy brief on communi-
ty health workers www.cdc.gov/dhdsp/docs/chw_brief.pdf date accessed
2014/12/03.
7. Amarchandi R, Sharmaii H, Krishnaniii A. Community health workers
can be trained to measure blood pressure: experience from India. Reg
Health Forum 2013; 17(1): 26–31.
8. Brownstein JN, Chowdhury FM, Norris SL, et al. Effectiveness of
community health workers in the care of people with hypertension. Am
J Prev Med 2007; 32(5): 435–447.
9. Brownstein JN, Bone LR, Dennison CR, Hill MN, Kim MT, Levine
DM. Community health workers as interventionists in the prevention
and control of heart disease and stroke. Am J Prev Med 2005; 29(5 Suppl
1): 128–133. DOI: 0749-3797.
10. Lehman U and Sanders D. Community health workers: What do we
know about them? The state of the evidence on programmes, activi-
ties, costs and impact on health outcomes of using community health
workers: Evidence and Information for Policy, Department of Human
Resources for Health Geneva, January 2007; 1–34.
hrh/documents/community_health_workers.pdf.
11. Siraj S,Shabnam F, Jalal CSB, et al. Shasthya Shebika’s role in improv-
ing infant and young child feeding practices in rural Bangladesh:
BRAC’s Experience. Geneva Health Forum, 2010.
12. Languza N, Lushaba T, Magingxa T, Masuku M, Ngubo T. Community
Health Workers. A brief description of the HST experience 2011; 1–8.
The Health System Trust, South Africa.
13. Puoane T, Bradley H, Hughes G. Community intervention for the
emerging epidemic of non- communicable diseases. S Afr J Clin Nutr
2006; 19(2): 56–62.
14. Abrahams-Gessel S, Denman CA, Montano CM, Gaziano TA, Levitt
N, Rivera-Andrade A, et al. Training and supervision of community
health workers conducting population-based, non-invasive screening for
CVD in LMIC: Implications for scaling up. Global Heart 2015; 10(1):
39–44.
15. Tsolekile LP, Puoane T, Schneider H, Levitt NS, Steyn K. The roles
of community health workers in management of non-communicable
diseases in an urban township. Afr J Prm Health Care Fam Med 2014;
6(1): 1–8. phcfm.v6i1.69.
16. Kruger HS, Puoane T, Senekal M, van der Merwe M-T. Obesity in
South Africa: challenges for Government and health professionals. Pub
Health Nutr 2005; 8(5): 491–500. DOI: 10.1079/PHN2005785/PMID:
16153330.
17. Parker WA, Steyn NP, Levitt NS, Lombard CJ. They think they know
but do they? Misalignment of perceptions of lifestyle modification
knowledge among health professionals. Public Health Nutr 2011; 14(8):
1429–1438.
18. Rivombo AM. A study of the challenges of adult learning facilitation
in a diverse setting with special reference to Soshanguve. Dissertation,
UNISA; 2014. URI: .
19. Gass DA, Curry L. Physicians’ and nurses’retention of knowledge and
skill after training in cardiopulmonary resuscitation. Can Med Assoc J
1983; 128: 550–551.
20. Crofts JF, Fox R, Draycott TJ, Winter C, Hunt LP, Akande VA.
Retention of factual knowledge after practical training for intrapartum
emergencies. Int J Gynaecol Obstet 2013; 123(1): 81–85. DOI: 10.1016/j.
ijgo.2013.04.015. Epub 2013 Jul 11.