Agricultural Migrant Workers Navigating the Health System: Access, Continuity of Care and the Role of Community Health Workers in De Doorns, Western Cape
Abstract
South Africa has an estimated two million documented and undocumented immigrants. In
addition, Statistics South Africa (2014) notes very significant internal migration. This mobile
population is affected by chronic communicable and non-communicable diseases such as TB,
HIV, and diabetes, although it has a Constitutional right to health and healthcare. Their quality of
healthcare and disease control also affects the general population and the burden on the health
system can be increased by inadequately managed chronic conditions as well as acute health care
needs. Access to healthcare and continuity of care reflect both patient agency and the health
system. Community Health Workers (CHWs) play an important role in linking communities and
patients to health services and vice versa. The aim of this study was to understand how
agricultural migrants in the Cape Winelands District of Western Cape Province of South Africa
navigated the healthcare system to access healthcare services including securing continuity of
care, and in particular the role of CHWs in this process, in order to inform policy and practice.
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