{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:02:25Z","timestamp":1789452145325,"version":"build-2803163510"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":257,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1463423626101753_as1\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This paper explores barriers and facilitators to training of community health workers (CHWs) and outreach team leaders (OTLs) in South Africa, from the perspectives of provincial managers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101753_as2\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ward-based Primary Health Care Outreach Teams (WBPHCOTs), comprised of generalist CHWs, supervised by OTLs (nurses), are a central pillar of South Africa\u2019s primary health care system, increasingly playing a critical role in extending services to underserved communities. As their responsibilities expand, effective and well-resourced training is essential; however, training approaches remain uneven across provinces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101753_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between July and August 2023, a descriptive exploratory qualitative study was conducted among 15 purposively selected provincial managers whose roles involved interfacing\/engaging with CHW responsibilities across the country\u2019s eight provinces. Telephone interviews were audio-recorded, transcribed verbatim and thematically analysed using Atlas.ti 23.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101753_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>Three key themes emerged: (i) current training practices and implementation approaches; (ii) training challenges and systemic gaps; and (iii) strategies for strengthening CHW and OTL training. Training is undermined by varying educational backgrounds and literacy barriers between CHWs and OTLs, a shortage of master trainers, and systemic constraints, particularly the absence of a dedicated training budget, inaccessible updated training materials, and logistical issues, including limited internet access and transport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101753_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Findings highlight the need for standardised, updated training materials, practical skills training, and translation of resources into local languages. Formal mentorship programmes, leadership and communication training for OTLs, and a dedicated training budget would alleviate systemic constraints. Increasing master trainers and partnerships with external organisations, to transfer skills and build internal capacity can strengthen support for CHWs and OTLs, improving service delivery and health system outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1463423626101753","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:05:38Z","timestamp":1789448738000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative study of provincial managers\u2019 perspectives on community health worker (CHW) and outreach team leader (OTL) training in South Africa: practices, systemic challenges, and strategic recommendations for strengthening primary health care"],"prefix":"10.1017","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9557-7424","authenticated-orcid":false,"given":"Natisha","family":"Dukhi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-987X","authenticated-orcid":false,"given":"Zainonisa","family":"Petersen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3337-8487","authenticated-orcid":false,"given":"Allanise","family":"Cloete","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1596-5617","authenticated-orcid":false,"given":"Yolande Lisette","family":"Shean","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9906-4474","authenticated-orcid":false,"given":"Shandir","family":"Ramlagan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-2344","authenticated-orcid":false,"given":"Adlai","family":"Davids","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"},{"name":"Nelson Mandela University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0950-0146","authenticated-orcid":false,"given":"Rindidzani","family":"Magobo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-3242","authenticated-orcid":false,"given":"Sizulu","family":"Moyo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056206b04","id-type":"ROR","asserted-by":"publisher"}],"name":"Human Sciences Research Council"},{"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"S1463423626101753_ref22","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v19i1.778"},{"key":"S1463423626101753_ref14","unstructured":"Jinabhai, C , Marcus, T and Chaponda, A (2015) Rapid Appraisal of Ward Based Outreach Teams. 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