One Million Community Health Workers

As we move towards the post-2015 era in global development, community health strategies continue to be proven as powerful mechanisms for achieving health systems change, especially in rural settings. African countries are increasingly adopting the One Million Community Health Worker (1mCHW) Campaign, and investing in community health workers (CHWs), striving to achieve the health-related Millennium Development Goals (MDGs), and ultimately to attain universal health coverage (UHC).

Nigeria was one of the first countries to join the Campaign after our launch last year. For the past year, health officials and various stakeholders in the country have been working on operational planning in the form of developing a program Roadmap. Nigeria has reached the next phase of their work with the Campaign, and we are pleased to unveil some of their preliminary plans.

In Nigeria, the relevant CHWs are currently known as Volunteer Village Health Workers (VVHWs). This group of health workers will be formalized as Village Health Workers (VHWs), operating under the supervision of the facility-based Community Health Extension Worker (CHEW) cadre. By bringing basic health services to Nigerian communities without access to primary healthcare, VHWs will help strengthen Nigeria’s overall health system and put Nigeria on track to reach MDGs 4, 5, and 6 by 2015. By expanding health access to rural communities, especially in the northern part of the country, which have the worst public health indices in the country, an increased investment in VHWs will also help Nigeria on the road to UHC.

Using a ratio of one VHW to approximately 500 individuals, Nigeria seeks to have over 100,000 trained VHWs deployed to the rural population living outside the reach of a health facility by 2015. This effort will reach 50% of the rural population, covering an estimated 54,275,000 people. Nigeria’s Roadmap is expected to be ratified this July at the next National Council on Health, an annual forum for all stakeholders in Nigeria’s health sector.

Nigeria’s Roadmap details the training, services, and evaluation designs that will be essential for the success of the VHW scale-up. The plan prioritizes particular high-need areas, determined by polio eradication efforts and disease burden, with a particular focus on the national priority areas: HIV/AIDS, TB and malaria, improving health awareness, increasing health seeking behavior, and other target indicators as determined by the Nigerian national strategic health plan. This scale-up prioritization approach enables VHWs to be quickly deployed to the whole country, especially regions that need them most.

The draft of Nigeria’s operational Roadmap is due to be finalized in the coming weeks. After the Minister of Health signs the final draft, a steering committee will be formed to direct the in-country launch of the Campaign, which will be supported by the Campaign team with regards to advocacy and preparing for implementation planning. Nigeria is working on an ambitious timeline for implementation, so the Roadmap process is moving along quite quickly.

The Campaign applauds all involved for so vigorously committing to community health. We are looking forward to seeing the operationalization of the Roadmap with collaborations from the Federal Ministry of Health through the National Primary Health Care Development Agency, Office of the Senior Special Assistant on the MDGs, international partners, and other stakeholders.