Abstract The use of community health workers (CHWs) has been advocated in both developed and developing countries for many years. This article reports the findings of a descriptive research study that explored the relationship between CHWs and nurses working in resource-poor settings in South Africa. The findings of the study highlight dimensions of complex interactions occurring between these two main providers of care at the district level. Understanding the primary interaction of CHWs with nurses offers further understanding of the broader role of CHWs within the district health system. It is evident that CHWs are ideally suited to play a pivotal role in supporting the public health services. However, their role and functions are not formalized and the effectiveness of programs is often not rigorously evaluated. This article discusses some of the issues related to this cadre of health worker and their role in public health care structures.