Organization: Khayelitsha Township
Country: South Africa
Khayelitsha is a township on the Cape Flats, outside of Cape Town, South Africa. A community-based project sought to increase awareness of primary prevention of non-communicable diseases (NCDs) by harnessing the power of community health workers (CHWs) as community change agents. The intervention was initiated in 2000, in response to the request of community members of Khayelitsha who had noticed an increasing number of people in their community suffering from diabetes and hypertension.
The first phase of the program focused on the health needs of the CHWs, over 90% of whom were obese and most of whom had misconceptions about the causes and consequences of obesity. An interactive training program was developed which aimed to empower CHWs with the knowledge and skills to make healthy choices and act as positive role models to others. The CHWs went on to organize awareness-raising events including a dramatized play on diabetes, discussions on healthy eating, fun group walks and a health club.
The diabetes drama was performed to 1100 people across 13 sites and at the end of each performance the audience was interviewed to assess their understanding. In 2005, the CHWs developed a health club called “Masiphakame Ngempilo yethu” (Let’s stand up for our Health). Members meet weekly and sessions are a combination of physical exercises, demonstrations, talks and discussions. Originally, the club had 35 members but by 2006 this had increased to 152. After 2 years, a study of 25 club members and 29 non-members demonstrated that club members tended to eat less red meat and were more likely to trim the fat from meat than non-club members.
The program faced several key challenges, in particular: high unemployment combined with easy and cheap access to unhealthy food; and high levels of crime and violence which discouraged people from undertaking outdoor physical activities. In spite of these difficulties, the program is still running, demonstrating the vital role that CHWs can play in the primary prevention of NCDs.