One Million Community Health Workers

As World Contraception Day approaches, the One Million Community Health Workers (1mCHW) Campaign would like to highlight the positive effects contraception has had on increased birth outcomes and children’s health. Community health workers (CHWs) have been pivotal to these efforts. They provide much needed access to contraception and family planning methods and play a central role in enhancing the livelihood of women and children.

Currently, the WHO estimates that up to 100,000 maternal deaths could be avoided if women used effective contraception. However, millions of women around the world are unable to access and use modern forms of contraception. This lack of access not only has severe implications for women, but it also has critical ramifications for the health and future of their children, family, and their communities.

Contraception helps provide women with the ability to control their own fertility, including the number, space and timing of pregnancies – all of which are important factors that influence the outcomes of pregnancy. For example, UNICEF estimates that by spacing pregnancies by at least two years increases the chance of child survival. However, approximately 87 million women unintentionally become pregnant each year. Unsurprisingly, many of these unplanned pregnancies occur amongst women who either do not have access to reproductive health services and education programs, or due to larger systemic factors, are largely ignored and stigmatized for seeking these services. This is particularly true for young women (those aged 15-25 years), where complications due to childbirth and pregnancy are one of the leading causes of death.

By tackling the unmet need for contraception and reproductive health education in underserved communities, such as young women, high-risk pregnancies and the associated maternal deaths can be avoided. CHWs play a crucial role in providing these women with contraception services and education. In Senegal, CHWs successfully provide Depot-Medroxyprogesterone Acetate (DMPA)- the most popular family planning method in Sub-Saharan Africa- to underserved women. In doing such, CHWs are strengthening Senegal’s ability to provide simple life-saving interventions to those who would otherwise have fallen through the gaps.

Contraception also has major implications for the future of children: a mother’s death is correlated with her children’s survival. It has been shown that when a mother dies her surviving children face higher risks of poverty, neglect, poor health, and mortality.  This is also true for children’s future nutritional status and school enrollment. Understanding these associated risks, access and uptake of contraception is increasingly recognized as a vital component of community-based interventions to for children’s health.

CHWs are at the forefront of integrating contraceptive services into wider community-based health initiatives for both women and children. In Nepal, CHWs have integrated contraceptive services into their health provisioning roles. This increased rural women’s access to modern contraception methods and has further strengthened the health systems ability to provide mothers and children with more comprehensive and holistic health services. By providing these services, CHWs can, and are, saving the lives of mothers and newborn babies.

The benefits of contraception don’t stop here. Studies have recognized that women who are able to control their reproductive health are also more likely to have higher education, and wages, and improved health.

Providing women with access and a choice to use contraception services, such as those provided by CHWs, is essential to the future of maternal and child health. World Contraception Day not only reinforces the amazing strides the global community has made towards providing access to modern and effective forms of contraception for women, but is also an essential reminder that women, when given the ability and choice to control their own fertility and reproductive health, will continue to foster enhanced health outcomes and education for themselves, their children and society as a whole.