5000 KZN community health workers take up permanent jobs after historic court victory

More than 5,000 Community Health Workers (CHWs) in KwaZulu-Natal have begun a new chapter of job security and formal recognition after the provincial Department of Health announced their permanent employment, following a landmark court victory won by the National Education, Health and Allied Workers’ Union (NEHAWU).

The decision forms part of a national process that will see over 27,000 CHWs permanently absorbed into the public health system, ending years of fixed-term contracts and employment insecurity.

The Congress of South African Trade Unions (Cosatu) in KwaZulu-Natal has welcomed the move as a decisive victory for organised labour and a breakthrough in the fight against casualisation.

In a statement, Cosatu KZN said it “welcomes and salutes the historic victory achieved by the National Education, Health and Allied Workers’ Union (Nehawu) following the successful court ruling that has paved the way for the immediate permanent employment of more than 27,000 Community Health Workers (CHWs) nationally.”

The federation said the move restores “dignity, job security, and full labour rights to workers who have for years been trapped in exploitation, insecurity, and uncertainty.”

“This breakthrough is a major victory in the struggle against casualisation, labour broking, and the abuse of fixed-term contracts,” Cosatu said, adding that it affirms the federation’s long-held position “that permanent work must be done by permanent workers, with full benefits and protection.”

Cosatu credited the outcome to years of sustained organising and legal action by Nehawu. The federation noted that in January 2025, the courts delivered what it described as a “watershed judgment” in favour of CHWs, after the union challenged the Department of Health’s “systematic and perpetual use of fixed-term contracts.”

The case argued that CHWs who played a decisive role during the Covid-19 pandemic, and who remain central to the implementation of National Health Insurance (NHI), deserve permanent employment, benefits, and security.

Cosatu said Nehawu continued to apply pressure after the court ruling to ensure that the settlement agreement was implemented.

As a result, the federation said there will be “the permanent employment of 5,000 eligible CHWs in KwaZulu-Natal” alongside “an interim increase in stipends for the remaining 16,867 CHWs for the 2025/2026 financial year, effective from September, with a promise for their consideration as well” and engagement on “the compensation for CHWs who have reached pensionable age.”

“This victory responds decisively to those who question the relevance of trade unions,” COSATU said. “It demonstrates in practice that organised workers, united under principled unions, can defeat exploitation, win in the courts, and force the companies and state to act.”

KwaZulu-Natal MEC for Health Nomagugu Simelane also welcomed the appointments.

“We are here to officially absorb and permanently employ over 5,000 Community Health Workers, who have served our communities with dedication, often under uncertain conditions,” Simelane said.

“This moment represents the dignity, recognition, and celebration of all of you, for never abandoning the people, even when your own futures were unclear.”

Simelane paid tribute to the role played by CHWs during major health crises. “During the HIV and AIDS pandemic, you ensured adherence to treatment, educated households about prevention, and supported families through the challenges of care,” she said.

“Similarly, during the Covid-19 pandemic, you made sure that communities followed precautions… You monitored those who were sick, and supported adherence to treatment protocols.”

She added that CHWs have been central to fighting other diseases, including tuberculosis, malaria, maternal and child health challenges, and chronic illnesses such as diabetes and hypertension, particularly in rural, township, and underserved areas.

“You have been the foundation of our primary health care system, going door-to-door, monitoring patients, supporting adherence to treatment, promoting prevention,” Simelane said.

Simelane also acknowledged the role of organised labour in achieving the breakthrough.

“I would like to take this opportunity to sincerely thank organised labour for their patience and support during these negotiations,” she said.

“Without your perseverance, today’s milestone would not have been possible.”

Addressing CHWs directly, the MEC urged them to protect their hard-won gains, manage their finances responsibly, and continue to uphold professionalism and confidentiality in their work.

“You are now ambassadors of the health system in every community you serve,” she said. “Continue to serve with discipline, compassion, and dedication. Make excellence your standard, not the exception.”

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