Strengthening the capacity of primary health care workers to drive optimal antibiotic use in the community
1
1 Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, CAPE TOWN, South Africa
2
2 Cape Town Systematic Healthcare Action Research Project (C-SHARP), Provincial Health Data Centre, Western Cape Department of Health and Wellness, University of Cape Town, CAPE TOWN, South Africa
3
3 School of Public Health, University of Cape Town, CAPE TOWN, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A222
ABSTRACT
BACKGROUND:
Community-based services play an integral role in health systems, especially in low-resource settings where access to health facilities is under strain. Community Health Workers (CHWs), who come from the communities they serve, are key role players who are well positioned to bridge the gap between the public and healthcare services. Accelerating interventions that empower and enhance the role of CHWs in public health, including for infection-related care, can support efforts aiming to respond to the threat of Antimicrobial Resistance (AMR).
METHODS:
We facilitated two rounds of participatory workshops with CHWs in partnership with two non-government organisations in Bishop Lavis and Nomzamo in Cape Town, South Africa. Using exploratory visual participatory methods, the first workshop established a baseline understanding of CHWs’ roles in primary care and identified areas for capacity strengthening in infection-related care. The second workshop was: 1) part-educational and 2) centred around AMR communication strategies. It included a pre-tested survey developed as part of a Delphi process that focused on identifying actionable, context-specific messages for AMR awareness.
RESULTS:
In July and October 2025, four sessions (two per workshop round) were conducted with 158 and 163 CHWs, respectively. Interpretative analysis showed that CHWs valued their roles and reported themselves as key agents for delivering public health services. A total of 163 CHWs completed the survey. CHWs ranked themselves as the most reliable sources for health information. Encouraging communities to finish antibiotic treatment was the most preferred message in local languages, while community events were rated as the most effective public communication medium.
CONCLUSIONS:
Interactive community-based workshops offer an opportunity for health systems strengthening to address AMR. This collaborative project provided important first steps to explore how engagement through community-based research can enhance the role of CHWs in delivering sustainable and context-specific public health interventions such as AMR awareness campaigns.
Community-based services play an integral role in health systems, especially in low-resource settings where access to health facilities is under strain. Community Health Workers (CHWs), who come from the communities they serve, are key role players who are well positioned to bridge the gap between the public and healthcare services. Accelerating interventions that empower and enhance the role of CHWs in public health, including for infection-related care, can support efforts aiming to respond to the threat of Antimicrobial Resistance (AMR).
METHODS:
We facilitated two rounds of participatory workshops with CHWs in partnership with two non-government organisations in Bishop Lavis and Nomzamo in Cape Town, South Africa. Using exploratory visual participatory methods, the first workshop established a baseline understanding of CHWs’ roles in primary care and identified areas for capacity strengthening in infection-related care. The second workshop was: 1) part-educational and 2) centred around AMR communication strategies. It included a pre-tested survey developed as part of a Delphi process that focused on identifying actionable, context-specific messages for AMR awareness.
RESULTS:
In July and October 2025, four sessions (two per workshop round) were conducted with 158 and 163 CHWs, respectively. Interpretative analysis showed that CHWs valued their roles and reported themselves as key agents for delivering public health services. A total of 163 CHWs completed the survey. CHWs ranked themselves as the most reliable sources for health information. Encouraging communities to finish antibiotic treatment was the most preferred message in local languages, while community events were rated as the most effective public communication medium.
CONCLUSIONS:
Interactive community-based workshops offer an opportunity for health systems strengthening to address AMR. This collaborative project provided important first steps to explore how engagement through community-based research can enhance the role of CHWs in delivering sustainable and context-specific public health interventions such as AMR awareness campaigns.
| eISSN: | 2654-1459 |
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