KwaZulu-Natal Health has permanently employed more than 5 000 community health workers (CHW), marking a triumph for the National Education Health and Allied Workers’ Union (Nehawu) after its long legal struggle over what it slammed as exploitation of CHWs.
Provincial Health MEC Nomagugu Simelane said the move represents dignity, recognition and celebration for the workers, who continued serving communities even during periods of uncertainty about their futures, reports The Witness.
The Labour Court had ruled in favour of the union in January last year, which was followed by a historic agreement reached in November 2025 between Nehawu and the National Department of Health to absorb the CHWs on a permanent basis.
On Tuesday, Simelane acknowledged the central role played by community health workers during some of the province’s most significant health crises, like HIV/Aids and the Covid-19 period.
Their permanent employment had been delayed for years due to severe financial constraints, requiring extensive negotiations with the National Treasury and the National Department of Health to reach a sustainable solution, according to Simelane.
It was not immediately clear how much the department or the National Treasury had budgeted for the programme.
Nehawu’s Harry Gwala regional secretary Mazwi Ngubane said the Labour Court ruling was the end of the exploitation of fixed-term contracts, and would target around 27 000 workers nationally.
“Our struggle has resulted in this milestone for people who have been exploited for many years. We welcome the development.”
Pushing for change
But in other districts, many CHWs are still earning stipends rather than salaries, reports Health-e News.
Lucky Mthombeni from Allanridge in the Free State started volunteering as a community health worker in 2002, immediately after completing matric.
More than two decades later, he remains deeply passionate about his work, but remains trapped in the cycle of short-term contracts that are renewed periodically, with no clarity about long-term employment.
Bulelwa Faltein, national Chairperson of the South African Care Workers Forum (SACWF), understands these struggles well. Faltein works at a public clinic in Mdantsane in the Eastern Cape, providing HIV testing, counselling and treatment support.
“It’s challenging but rewarding,” she said. “I feel proud to be making a difference in my community.”
The SACWF, formed in 2014 in response to the widespread challenges faced by CHWs, including poor working conditions, lack of recognition and inadequate compensation, took the matter to the Labour Court with Nehawu, resulting in the landmark ruling on 23 January 2025 that found the repeated use of fixed-term contracts for ongoing and essential services violates the Labour Relations Act.
“That judgment was a major victory for CHWs,” Faltein said.
Nina Benjamin, a facilitator at Labour Research Services (LRS), said her organisation worked closely with care workers, including CHWs, to promote decent work and fair labour practices.
“I’m shocked that people have been working for more than 10 years without job security or employee benefits,” she says. “It highlights the urgency of this issue. “CHWs are the backbone of primary healthcare in many communities. They deserve dignity, stability and recognition.”
The Witness article – KZN Health absorbs more than 5 000 community health workers (Open access)
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