Letters

How we can empower volunteer health workers

doctors

Doctors perform a pacemaker placement surgery at a medical camp in Nairobi. FILE PHOTO | NMG

Three years into the pandemic, Covid has taught us many lessons about the toll of health inequities around the world – particularly in developing nations.

That’s why we are so inspired by the tens of thousands of frontline community health volunteers (CHVs) in Kenya – also known as community health workers (CHWs) – who improve the lives of millions of people.

In 2021, the Health ministry worked with partners to develop a roadmap to digitise community health and roll out support for all 95,000 CHVs.

Now more than ever, this work is vitally important, as they not only deliver a wide range of primary health services to communities but they’re also raising awareness and driving demand that is encouraging target populations to get Covid vaccination.

According to the ministry, only 31.5 percent of the adult population was fully vaccinated by June 21 – a number that must increase to slow the spread of the virus, especially in light of a new wave of infections.

The Health Worker Training Initiative is one collaboration that’s prioritised supporting Kenyan CHVs throughout the pandemic.

Beginning in 2019, this partnership between biopharmaceutical companies, foundations and NGOs supports community health workers in several sub-Saharan African countries. Through this work, we’ve learned that three targeted investments in CHWs will make an outsized impact on effectiveness and equity in the coming years.

Well-supplied, well-trained, and well-paid workers: We know community health workers need skills, supervision, reliable access to supplies – and pay. Community health volunteers in Kenya do not receive a salary – although Kenya’s new Community Health Strategy speaks to the importance of compensating them. Current estimates suggest four out of five CHWs throughout Africa are unpaid.

In Liberia, where Last Mile Health has been a partner to the government for nearly 15 years, salaried CHWs treat more than 50 percent of malaria cases in rural areas — a level that has been maintained throughout the pandemic.

Digitally enabled: Community health workers and their supervisors don’t necessarily need dazzling high-tech solutions – but having appropriate mobile technology at their fingertips makes a world of difference.

Public-private partnerships: CHWs are only as strong as the health systems in which they work.

Funders need to work together with governments to strengthen existing systems and ensure they are locally owned, rather than creating parallel ones.

We call on the private sector and governments to invest more in this vital area now – before the next pandemic hits.

We are eager to see more public-private partnerships that put the government in the driver’s seat, to ensure sustainability and the inclusion of best practices in their community-based health systems.

When it comes to global health, and our collective goal of supporting healthier and more resilient communities around the world, few investments have a deeper and more lasting impact than supporting digitized and paid community health workers.