One Million Community Health Workers

Last week in Addis Ababa, the UN Special Envoy for Financing the Health Millennium Development Goals and for Malaria (MDG Health Envoy) released their report Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations. We were incredibly excited to see the launch of this report and the impact that its findings will have on the CHW community.

As the global community continues to work together to strive for the Millennium Developmental Goals (MDGs), the report serves as a reminder of key issues that was must still tackle and illustrates way in which they can be solved. While we have faced challenges in reaching the MDGs, these challenges have only served to place more emphasis on the areas of health that we must continue to focus on in the post-2015 era.

There are three key takeaways to the report:
1. “There is a strong case for investment in CHWs as a component of primary health care.”
2. “When building CHW programs, maintain ten core principles and a focus on performance management will ensure return on investment (ROI).”
3. “Sources of financing for CHWs exist, but countries must be proactive to assemble a financing pathway for their system.”

These findings support what we at the 1mCHW Campaign have been saying, that it is critical to work on supporting health workers to build healthy communities.

When the Ebola epidemic hit West Africa, health systems were put to the test. It can be seen in the aftermath, as the MDG report notes, that CHWs played an important role in helping fill vital gaps. CHWs can help reduce the risk of another epidemic, and this is reason enough for continued investment in community health. By using CHWs to increase access to healthcare it is believed that, “…CHWs could prevent up to 3 million deaths per year.” This is a number that simply cannot be ignored. Furthermore, not only are CHWs helping in the fight to provide universal health coverage (UHC), but they also. “…yield additional societal benefits including the empowerment of women and increase in income for households of paid CHWs.”.

The scale-up of CHW programs cannot happen overnight and must be done with care and thought. MDG Health Envoy states that the ten principles to support CHW program development are:

• Addressing Program Leadership
• Health System Integration
• Community Engagement
• Financing, Monitoring
• Health Worker Training
• Supervision
• Management
• Support
• Incentives

By keeping these principles in mind, effective CHW programs can be built that actually serve the needs of the communities at hand.

In addition to maintaining these ten guiding principles, stable financial support must also be established for the successful scale-up and maintenance of CHW programs. MDG Health Envoy suggests that, “Countries may follow a four-step process to develop a financing pathway in support of their overall health workforce development plans: determining the required program scale, costing the plan year-by-year, setting financing targets for each year by funding source, and identifying specific funding mechanisms to fulfill these targets.” While these steps may take time, when effectively executed CHW programs are able to flourish and have their impact optimized in the long run.

With the release of this report CHW programs are sure to continue to grow, as they have been proven effective time and time again. CHW programs help promote healthy communities by integrating community members into the health system and providing forums for community feedback and engagement. They also improve the economic health of countries by limiting the amount of money that must be spent on making up for inadequate healthcare access. When CHW programs exist in communities they can provide care in areas such as maternal, neonatal, malaria, malnutrition, and HIV, which are often otherwise neglected, thus mitigating expenses and “…increasing the immediate value of ever dollar invested”.

You are able to read the full report here.