Building community capacity in diabetes care: Perspectives of community health workers.

Background: Diabetes is a global public health concern. Approximately, 79% of people living with diabetes reside in low- and middle-income countries. Community healthcare workers (CHWs) provide basic care to communities, including people living with diabetes in South Africa; however, their contribution still needs to be explored. Aim: To explore the perceptions of CHWs regarding their roles in diabetes care. Setting: This study was conducted at primary healthcare clinics in the Tshwane District, located in the northern part of Gauteng province in South Africa, where CHWs form part of ward-based outreach teams. Methods: Using a descriptive qualitative research design, four focus group interviews were conducted with 32 CHWs with 5 or more years of experience and involved in providing care to people living with diabetes. The Dynamic reading, Engaged code book development, Participatory coding, Inclusive reviewing and summarizing of categories, Collaborative analysis, Translating (DEPICT) approach for collaborative qualitative data analysis was used. Results: The participants indicated that their roles focused on health education, specifically related to diet, lifestyle changes, medication, involving family and self-care, support and monitoring. Conclusion: CHWs play an important role in the screening, continuous monitoring and referral of people living with diabetes. It is important that training and support for CHWs are aligned and informed by evidence and the needs of the communities they serve. Contribution: The results may assist in the development of appropriate competencies, to inform programs and in-service training topics and regulate the practices of CHWs.