PURPOSE AND RATIONALE OF THE QUALIFICATION
Purpose:
This Qualification is for any individual who is, or wishes to be, involved in Ancillary Health Care services. A learner who has achieved this qualification will integrate a range of awareness and competences to practice the roles of health promoter, health provider and health networker within a community development context. Learners working
towards this Qualification will find that the acquisition of competence in the Unit Standards, which make up the Qualification, will add value to their work performance. This Qualification is intended to enhance the provision of entry-level service within the field of health care within all sectors. Learners who complete this qualification will have better self and social awareness and will possess a range of thinking and problem solving skills. In addition, they will possess the competence required to perform community health functions in a complex developing world context. They will have the skills required for employment by a range of government and social sector employers, will be in possession of a further education and training certificate and will be eligible for certain credit recognition in various higher education health qualifications. Qualified learners in this field will provide a service that will assist communities to better manage their own health and wellness. They will have the skills to work as team members and as providers of support services within a multidisciplinary health care team. In addition, recipients will be able perform some of the following according to their choice of electives:
• Facilitate and administrate community health activities/centre via supervision of a team of health care workers.
• Provide community health care.
• Provide care for persons with intellectual and physical disabilities.
• Assist in planning advocacy campaigns to support primary health care initiatives.
• Assist in facilitating and implementing primary health care projects within the community.
• Engage in inclusive communication with the Deaf in South Africa.
• Practitioners will generally carry out their roles within the context of:
> The client's home.
> A community care centre.
> The broader community. Rationale:
The South African Government is committed to combining the national human resource development strategy with the rapid upgrading of service delivery to all of the nation's communities. An integral part of this strategy is initiatives to strengthen communities` abilities to empower themselves to participate in the political, economic, social and development spheres of South African life. Two key components in this empowerment are communities` abilities to integrate with and access state services, and their ability to further the health and wellness of community members. There is no doubt from the international experience of Community Health Workers (CHW) that they play a role in improving basic health status of communities. In South Africa, the important supportive role of CHWs in the provision of health care services has been extensively documented. This contribution is further exemplified in those parts of the country where there is a shortage of professional health workers to provide the necessary health care services based on identified needs. The Department of Health is leading the implementation of a multi-professional team-based approach to health care delivery, where each member of the team has a defined role to ensure that there is no duplication and overlapping of functions. Since Ancillary Health Care workers are found throughout the country - from established urban areas to scattered farms and deep rural areas - the type of learner to enter for this qualification is equally varied. The first level qualification in the bouquet is at NQF Level 1, ABET Level 4 and the last qualification is the FETC:
Community Health Work at NQF Level 4. As a result, learners will vary in age, in background and in level of formal schooling. The common denominator is the desire to help their fellow beings. LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING
• Mathematical Literacy at NQF Level 3.
• Communication at NQF Level 3.
• The Unit Standard ID 254222: Demonstrate stress management as a self-help tool at NQF Level 3. Recognition of Prior Learning:
The structure of this Unit Standards' based Qualification makes the Recognition of Prior Learning (RPL) possible. RPL will be done by means of an Integrated Assessment during which the learner should be able to demonstrate competence in the knowledge, skills, values and attitudes implicit in this Qualification. RPL may allow for accelerated access to further learning. All RPL is subject to quality assurance by the relevant accredited Education and Training Quality Assurance Body (ETQA) or ETQA that has a Memorandum of Understanding in place with the relevant ETQA. RPL is conducted by a registered assessor who is accredited by the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA. Access to the Qualification:
Access to this Qualification is open, bearing in mind the conditions of the Learning Assumed to be in Place. It is preferable, however, for the learner to have completed 12 formal years of schooling or equivalent vocational qualifications. INTERNATIONAL COMPARABILITY
There are no internationally recognised qualifications for Ancillary Health Care workers. This qualification, as an outcomes' based education programme, is uniquely South African and is appropriate for the unique requirements in this country. It can be adapted to neighbouring (SADC) and other third-world countries. Other countries, affected by the global shortage in the health sector workforce, have responded with initiatives using Community Health Workers and have created facilitative training initiatives for them. However, much Ancillary Health training is reactive in response to regional needs rather than proactive, as this qualification attempts to be. Whilst the content of qualifications and skills programmes varies from country to country, based on current urgent needs, they are comparable in content and level. Common themes enable Community Health Workers to act as a bridge between the community and the health care system and deal directly with some simpler community based problems. The academic background and training of Community Health Workers vary widely in different regions. According to the World Health Organization, Community Health Workers should have a level of basic education that enables them to read, write, and do simple mathematical calculations. Globally, Community Health Workers provide basic health services to a large number of populations, including poor people from rural areas. However, their efficiency is limited by lack of knowledge and skill. Continuing medical education and training programmes should provide problem oriented education, which would enable Community Health Workers to conduct programmes and provide primary health care. Nepal, India, Bangladesh, Brazil, South East Asia:
Countries and continents using Community Health Workers include, but are not limited to, Nepal, India, Bangladesh, Brazil, South East Asia and Africa. United States of America, Canada and the United Kingdom:
In some parts of the United States, Canada and the United Kingdom, in response to changing demographics and an influx of immigrants from diverse regions (Cambodia, Vietnam, and Thailand), ancillary health care programmes to and training for Community Health Workers have also been introduced. United States of America:
The Minnesota Department of Health uses bilingual Community Health Workers to act as health guides or bridges between the health care system and patients in immigrant communities. Their roles include informal counselling, social support, and health education, enrolment in health insurance programs, advocacy, and referral and follow up services. Community Health Worker programmes have been found to be both cost effective and to improve health outcomes among minority and immigrant populations. Training programmes have been developed by the Healthcare Education Industry Partnership and the Blue Cross Blueshield Foundation and are presented at a number of institutions, e.g. The Minneapolis Community & Technical College, which] provides a Community Health Worker Enhanced Role Certificate consisting of 17 Credits made up as follows:
• HCCC 1010 Behaviours for Success in Health Careers (0.50).
• HCCC 1020 Communication in Healthcare (1.00).
• HCCC 1030 Awareness and Sensitivity to Client Needs (0.50).
• HCCC 1040 Respecting Client and Staff Diversity 0.50.
• HCCC 1050 Healthcare Safety and Standard Precautions 0.50.
• HCCC 1060 Legal Issues in Health Care 0.50.
• HCCC 1070 Ethics 0.50.
• HCCC 1080 Nursing Assistant Skill Set 2.00.
• CMHW 1000 The Community Health Worker: Role, Advocacy and Outreach 3.00.
• CMHW 1015 Organization and Resources: Community and Personal Strategies 2.00.
• CMHW 1025 Teaching and Capacity Building 2.00.
• CMHW 1035 The Community Health Worker: Legal and Ethical Responsibilities 1.00.
• CMHW 1045 Community Health Worker Coordination, Documentation and Reporting 1.00.
• CMHW 1055 Communication Skills and Cultural Competence 2.00. Other states with diversity issues utilising such programmes include Texas and California. Project based training:
In much of Africa, Ancillary Health Care workers are trained as part of international aid projects. Kenya:
The community based HIV/AIDS Prevention and Support Project used and trained Community Health Workers using a 'cascading' method.
