MRC PhD students

PhD student, Karen Daniels from the Health Systems Research Unit is currently focusing her research on the topic of “Understanding Lay Health Workers in South Africa: The people, the policies and the evidence.”

Lay health workers add great value to the health care system, both nationally and internationally in terms of increasing health care access for the poor. However, despite extensive research into the role of the lay health worker, few studies have explored the impact on individuals who take on this role (Daniels, K, et al 2005).

In looking at our own health system, one of the key areas in which lay health workers are hoped to be utilized is that of HIV/AIDS, particularly for home-based care. Concerns are raised as to whether this community home-based care targets the poor and more specifically women (Marais, H, 2006). 

A small study was conducted, where the question of the impact on lay health work, with lay health workers providing care to tuberculosis patients was highlighted. It concluded to show that even though women felt that they had benefited by taking on this role, that they were now burdened with extra responsibilities on top of their domestic duties (Daniels, K, et al 2005). Essentially, respondents suggested that becoming lay health workers enhanced their opportunities, but felt it encroached upon their domestic time.

The question therefore is; how we best ensure that lay health workers are adequately protected if they are able to make such a positive impact on health service delivery? The key focusing question of this PhD study is; how to enhance health care delivery through the incorporation of lay health workers without placing a further burden on the poor, while at the same time ensuring that those who take on this duty receive the maximum possible benefit for their efforts.

In combining qualitative and quantitative research, this PhD asks:
•           What evidence exists to support the utilization of health workers?
•           How are lay health workers portrayed in modern policy making?
•           What can we learn through speaking to lay health workers themselves?