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September 10, 2025PLOS Global Public HealthOpen Access

A realist perspective on optimizing community health workers’ roles and functions to deliver integrated people-centred care

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Authors

UBUsangiphile E ButheleziUniversity of KwaZulu-NatalARAndré Janse van RensburgAfrica Health Research InstituteMMMosa MoshabelaUniversity of Cape Town

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Implication

Realist evaluation reveals how contexts and mechanisms affect community health workers’ effectiveness in delivering integrated care.

Key Points

  • Community health workers’ effectiveness is influenced by the context-mechanism-outcome interactions in care delivery.
  • Key findings include meta-mechanisms of trust, legitimacy, and motivation crucial for engaging communities and coordinating care.
  • This realist evaluation employed thematic analysis in five rural communities of KwaZulu-Natal, highlighting systemic challenges.
  • Governance gaps hinder the delivery of integrated people-centred care, suggesting urgent reforms in workforce integration and resourcing.

Cite This Study

Buthelezi et al. (2025) studied this question.

synapsesocial.com/papers/68c188579b7b07f3a06123eahttps://doi.org/10.1371/journal.pgph.0004926
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