One Million Community Health Workers

In March 2008, I stood as one of more than a thousand people in a crowded conference hall north of Kampala, Uganda attending the first global forum for human resources for health. I was surrounded by nurses, community health workers, public health practitioners, doctors and pharmacists from all over the continent. On a distant stage towards the front of the room, I watched in amazement as a draft of the Kampala Declaration was displayed for commentary from the crowd. After spirited discussion, the Kampala Declaration stood as the common vision of a varied group of people. The spirit of crowd-sourced input has always been a part of how community health worker systems are developed, and it’s a guiding principle of the One Million Community Health Worker Campaign (1M CHW campaign).

The 1M CHW campaign isn’t owned by any one organization, although it is propelled by the urgency to improve the quality and quantity of CHWs in order to achieve the Millennium Development Goals. The campaign is built upon a group of “starter networks” that represent a generation of transformative advocacy initiatives, successful pilots, private sector partners, technical bodies and national initiatives (see our growing set of partners). We’re in the process of making it easier for other organizations and networks to take an active part in the goals of the campaign, which focus on overcoming obstacles to scaling-up and upgrading national CHW programs.

Since the high-level endorsements of the 1M Campaign at the World Economic Forum and African Union, we have focused upon deepening the campaign’s connections to regional networks. We’ve been able to do this with the advice and guidance of people like Professor Francis Omaswa, who now leads the Africa Platform for Human Resources for Health. It’s only fitting that Professor Omaswa (former Exec Director of GHWA) has been guiding us through this process, because he was the extraordinary person who led a thousand people to finalize the aforementioned Kampala Declaration in real-time.

The campaign secretariat has created 4 working groups that we will be using to absorb crowd-sourced input to drive 1M CHW campaign activities. I’ll explain the first two in this post:

1) Managing Scale Up:

CHW Support Systems
This group will focus upon 1) identifying critical supplies for CHWs and supporting volume pricing, 2) creating more definition on how CHWs integrate with primary health systems using reliable communication protocols with other front line health workers, and 3) developing customizable support packages for scaling up CHW systems (i.e. training systems, management workflows, mobile infrastructure, monitoring systems etc…).

Counting and Measuring Results
We’re working with technical partners like CapacityPlus and national ministries of health to count the CHWs that this campaign is designed to support, and ensure their activities are linked to the MDGs.

CHW Wireless Infrastructure
We’re looking for innovative solutions to map the wireless coverage in rural areas, which will help the 1M CHW campaign prioritize available resources to improve connectivity for mobile phones. This should be coordinated with regionally-based private sector partners who can procure, equip and maintain equipment for CHWs.

2) Rapid Training:

There is a lot of content available for CHWs. In most countries, national curricula exist. The 1M CHW campaign is looking for the best ideas to distribute content in a range of accessible formats, while building strong links with management and supervisory mechanisms. We’re not looking for simply innovative ideas, but field-tested solutions that you’ve seen work for CHWs: Skills and competencies as well as solutions to bring projects to scale. In the process, we’re bringing together curricular content for CHW systems, effective pedagogical methods, and continuous assessments for CHW knowledge. Fortunately, there has been significant work in this area that we’re counting on making broadly available.