One Million Community Health Workers

Feb 28, NEW YORK: A report by Dr. Henry Perry and Rose Zulliger of the Johns Hopkins Bloomberg School of Public Health estimates that using community health workers (CHWs) to provide health services to families can significantly improve health outcomes and potentially save the lives of 3.6 million children per year. These important findings support the urgency of the One Million Community Health Workers Campaign.

The groundbreaking report, commissioned by the MDG Health Alliance, comprehensively assesses evidence related to the effectiveness of CHW programs for achieving the Millennium Development Goals (MDGs). Prior research focused on specific health interventions but not on the delivery of those interventions to those who need them most.

The One Million CHW Technical Taskforce, convened by the Earth Institute in 2011, posited that CHWs — working in partnership with other frontline health workers and anchored in the primary health care system — are crucial for delivering effective, community-based interventions to meet the health-related MDGs.

Current scientific evidence is overwhelmingly supportive of the Taskforce’s hypothesis. The authors of this new report conclude that,3.6 million child deaths could be averted if CHW interventions are expanded to maximum coverage in the 73 countries with the highest burden of child mortality. This represents almost half of the deaths of children under five years of age presently occurring. Around 10 percent of children in sub-Saharan Africa die before reaching their fifth birthday, overwhelmingly of preventable and treatable causes.

Given the enormous potential impact of CHWs on child and maternal health, the report serves as a rallying cry for greater investment in CHW programs. “The integral part that CHWs play in primary health care systems has never been more clear. This study reinforces what a powerful role a CHW can have in their community,” says Dr. Prabhjot Singh, co-chair of the One Million CHW Campaign. The campaign will work closely with governments and aid agencies to mobilize additional funds from existing and new donors, as well as from the host countries consistent with their budgetary means, to train and deploy health workers.

Many countries are struggling to make progress toward the health-related MDGs partly because so many people live in rural areas beyond the reach of well-staffed and well-provisioned health care. Trained CHWs — equipped with supplies and with smart phones that enable them to get training, advice, data and access to emergency services — can transform the rural health situation.  Smart phones also allow for smart systems, in which health managers quickly receive valuable information entered by the community health workers.

The new report finds that the services delivered by CHWs that hold the most promise for reducing maternal and child mortality are: family planning, distributing misoprostol (for reducing the risk of post-partum hemorrhage in women who give birth at home), essential neonatal care at home, promoting exclusive breastfeeding during the first six months of life, integrated community case management of childhood illnesses (pneumonia, diarrhea and malaria), and promoting and providing immunizations.

Three countries in particular have effectively utilized CHWs and made extraordinary progress in achieving the health MDGs: Brazil, Bangladesh and Nepal. The One Million CHW Campaign looks to apply the lessons from these successful experiences to African countries.

The new African Union chairperson, Ethiopian Prime Minister Hailemariam Dessalegn, announced his strong support for the One Million CHW Campaign last month. The AU chair and several African leaders agreed that urgent effort is needed for African nations to meet the MDGs, and that the new healthcare campaign will be critical to success. As AU chairperson, Prime Minister Hailemariam will be working closely with the campaign to train and deploy hundreds of thousands of health workers this year.

The One Million CHW campaign is an initiative of the UN Sustainable Development Solutions Network, and is backed by the UN MDG Advocates and the UN Broadband Commission. The campaign and Professor Jeffrey Sachs, in his role as special advisor to the UN Secretary-General on the Millennium Development Goals, will work closely with the international community — businesses, UN agencies, donor organizations, telecommunications companies — to build partnerships to support the national programs. In addition, a leadership committee is being formed, with senior African leaders.

Related Links

The “Review of CHW Effectiveness for MDGs” report.

The report was commissioned by the MDG Health Alliance

The One Million Community Health Workers Technical Taskforce report