Strengthening health systems and equity through community leadership: a youth‑led initiative integrating youth community health workers into clinics shows a 200% increase in service utilisation by young people—a call for immediate government action
1
1 Community Engagement Division, Rhodes University, Makhanda, South Africa
2
2 Ubomi Bethu Programme, Ubunye Foundation, Makhanda, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1669
ABSTRACT
INTRODUCTION:
Despite Department of Health targets for 70% clinics to provide Adolescent and Youth Friendly Services and revised comprehensive legal and policy frameworks, studies indicate that few young people access health services. They cite lack of confidence in providers, providers attitude, confidentiality breaches, lack of privacy, inconvenient operating hours, long waiting times and ineffective care. In response, young women from the Ubunye Foundation, a rural community-led NGO in the Eastern Cape, volunteered as Youth Community Health Workers (YCHWs) in local clinics. Their aim was to demonstrate how government investment in formal YCHW posts could expand youth access to care for those aged 10–35 years
METHODS:
Since 2024, ten Ubunye Foundation members aged 17–29 have served as YCHWs across five rural government clinics in Ngqushwa Municipality. Supported with training, mentoring, stipends, and internet access by Ubunye, the YCHWs were fully integrated into clinic operations. Their presence increased youth friendliness, reduced fear, built trust, and addressed provider bias. They also strengthened referral pathways to local legal, social, and counselling services while helping young people understand and claim their rights to health care.
RESULTS:
Following YCHW integration, on average 2211 young people (14–35 years) accessed the clinics monthly. Annual service utilisation rose by 340%, from 6020 single person visits in Year 1 to over 26542 in Year 2. YCHWs contributed to a more responsive youth centred model characterised by personalised care, dedicated access points and times, clinic and community outreach, household visits, and a multi sectoral referral system linking youth to local social, legal, law enforcement, psychosocial services.
CONCLUSIONS:
This community-led model demonstrates the transformative potential of investing in Youth Community Health Workers. Their supported placement in rural clinics rebuilt youth centred care, reduced longstanding barriers, and expanded pathways to local socio legal and psychological support—providing compelling evidence for government adoption and scale-up.
Despite Department of Health targets for 70% clinics to provide Adolescent and Youth Friendly Services and revised comprehensive legal and policy frameworks, studies indicate that few young people access health services. They cite lack of confidence in providers, providers attitude, confidentiality breaches, lack of privacy, inconvenient operating hours, long waiting times and ineffective care. In response, young women from the Ubunye Foundation, a rural community-led NGO in the Eastern Cape, volunteered as Youth Community Health Workers (YCHWs) in local clinics. Their aim was to demonstrate how government investment in formal YCHW posts could expand youth access to care for those aged 10–35 years
METHODS:
Since 2024, ten Ubunye Foundation members aged 17–29 have served as YCHWs across five rural government clinics in Ngqushwa Municipality. Supported with training, mentoring, stipends, and internet access by Ubunye, the YCHWs were fully integrated into clinic operations. Their presence increased youth friendliness, reduced fear, built trust, and addressed provider bias. They also strengthened referral pathways to local legal, social, and counselling services while helping young people understand and claim their rights to health care.
RESULTS:
Following YCHW integration, on average 2211 young people (14–35 years) accessed the clinics monthly. Annual service utilisation rose by 340%, from 6020 single person visits in Year 1 to over 26542 in Year 2. YCHWs contributed to a more responsive youth centred model characterised by personalised care, dedicated access points and times, clinic and community outreach, household visits, and a multi sectoral referral system linking youth to local social, legal, law enforcement, psychosocial services.
CONCLUSIONS:
This community-led model demonstrates the transformative potential of investing in Youth Community Health Workers. Their supported placement in rural clinics rebuilt youth centred care, reduced longstanding barriers, and expanded pathways to local socio legal and psychological support—providing compelling evidence for government adoption and scale-up.
| eISSN: | 2654-1459 |
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