This study is focussed on farms situated in the Boland health district of the Cape Winelands, South Africa. The aim was to explore, understand, and describe the perceptions of farmers of having a trained lay health worker (LHW) on the farm. A qualitative study design was applied. Data were collected during six in-depth interviews and two focus group discussions with participating farmers. The results show that farmers remained positive about the concept of having a trained LHW on the farm, but became frustrated with the lack of recognition of their and the LHWs' contribution by the public health service. Farmers who are willing to participate and remain active are key to introducing a farm community-based LHW intervention. Sustainable LHW interventions are dependent on public health sector support and recognition of all role players.