South Africa has proposed a move to institute a national health insurance (NHI) programme, and to improve access to primary healthcare.
As part of the project, school health programmes will be strengthened and specialist teams, including gynaecologists, paediatricians and advanced midwives, will be assigned to each of South Africa's 52 health districts.
This is expected to address the country's high rates of infant, child and maternal mortality.
The roll out ward-based primary healthcare outreach teams of community healthcare workers (CHWs).
Each worker is expected to be responsible for 250 households, or about 1,000 people, according to draft discussion papers.
David Sanders, professor and founding director of the School of Public Health at South Africa's University of the Western Cape, says this ratio is far too large.
In an interview with IRIN, Sanders stated "How is one health worker going to cover 250 households? [It's] impossible."
In a country with an HIV prevalence of about 18 percent, CHWs are also prohibited from performing the heel pricks necessary for dried bloodspot infant HIV testing, he pointed out.
Decentralizing this function could multiply the number of HIV-positive babies diagnosed and treated.
HIV and AIDS in South Africa are major health concerns, and around 5.5 million people are thought to be living with the virus in South Africa.
HIV (human immunodeficiency virus) is the retrovirus that causes the disease known as AIDS (Acquired Immunodeficiency Syndrome). South Africa has more people with HIV/AIDS than any other country.
With an unemployment rate that the Congress of South African Trade Unions estimates is as high as 40 percent, the government has implemented infrastructure projects to create jobs.
Sanders argues that if the country invested in training more CHWs, it could create employment and improve health indicators.
"If we had part-time community health workers, [with] each worker covering 25 households - not 250 - they could do that on a part-time basis and receive a part-time wage," he said. "We could create 400,000 or 500,000 jobs and get the health coverage we need."