One Million Community Health Workers

Last Friday NGOs, governmental organizations, and medical societies from across the world celebrated World Contraception Day! These organizations come together every year to spread the word and raise awareness about contraception and reproductive health. World Contraception Day (WCD) centers on a vision where all pregnancies are wanted.

Unfortunately, access to contraception and family planning services is not equal around the world. Sub-Saharan Africa has the highest fertility rates and projected population growth in the world; much of this is due to the lack of access to family planning services. In a recent blog post, the One Million Community Health Worker (1mCHW) Campaign described how community health workers (CHWs), who are vital to family planning and reproductive health services, were facilitating access to such crucial services for rural Nigerians.

Last week, UNICEF published their progress report entitled “Committing to Child Survival: A Promise Renewed.” A Promise Renewed (APR) is a global movement to reduce preventable maternal and child deaths by accelerating progress on maternal, child, and newborn survival. Born out of the United Nation’s Every Woman Every Child strategy, APR works to address the causes of child and maternal mortality, focusing on the 25 countries that account for 80 percent of under-five deaths. These causes may be overt (like diarrhea and intrapartum complications) or underlying (such as women’s education and empowerment).

The recent progress report introduced some important findings that inform the 1mCHW Campaign’s work in maternal and child health. The most interesting findings in the APR progress report include:

• Under-five mortality has declined by almost half since 1990; it is falling faster than at any other time in the past two decades.
• Between 1990 and 2013, 223 million children around the world still died before their first birthday.
• Sub-Saharan Africa and South Asia together account for 4 out of 5 under-five deaths globally.
• Pneumonia, diarrhea, and malaria are still the biggest killers of children under 5.
• Neonatal deaths make up 44% of all under-five deaths.

What do all of these findings mean for the 1mCHW Campaign? We must renew our promise to maternal and child health by investing in CHWs as a means to help eradicate under-five mortality. The first hours of life are crucial to a baby’s survival, and having a skilled health professional present during birth strongly reduces the likelihood of mortality. CHWs are also key in pre- and post-natal care for mothers, especially in rural settings. If we are going achieve the goal of reducing child mortality by two-thirds by 2015, we must continue to invest in solutions that connect mothers and children with quality care in the most essential contexts. CHWs are a crucial part of this puzzle.