Community Health Workers: challenges and progress in Africa
19 - 21 June 2012 | Addis Ababa - The USAID-sponsored Community Health Worker (CHW) Regional Meeting held in Ethiopia was attended by over 60 government and NGO representatives from six African countries: Ethiopia, Kenya, Mali, Rwanda, Uganda, and Zambia as well as participants from international NGOs and organizations. The meeting was designed by Initiatives Inc. and USAID/HCI to share new tools and strategies to strengthen the functionality of government and NGO CHW programs; facilitate dialogue about challenges and best practices among participating countries and identify and support evidence-based strategies for scale up.
The global shortage of health human resources is estimated to be 4.3 million; the dearth of health workers presents significant challenges to reaching the millennium development goals and to meeting the overall health needs of communities. One of the ways countries have sought to plug the HRH gap and increase access to essential health services is through the recruitment and deployment of community health workers. The positive effects of CHW programs in contributing to improved program achievements have been documented, but so have challenges of managing CHW programs and ensuring quality service. At the request of the USAID MCH team, the Health Care Improvement (HCI) Project developed the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Toolkit to help measure and improve CHW program functionality.
The objectives of the meeting were:
- to provide a forum for policymakers and program managers to share best practices, innovations and challenges in CHW programming;
- to familiarize participants with the CHW AIM tool and its applications, including assessment, evaluation and improvement of CHW programs;
- to develop a framework for analyzing key constraints and enablers for achieving functional, scalable and sustainable CHW programs.
Prof. Miriam Were represented the iERG at the meeting and as a Community Health Strategy Goodwill Ambassador for Kenya provided an inspiring keynote address on the role of the community in supporting CHWs. Miriam Were believes the community needs to be the foundation for national health services. She presented the global health resource crisis challenges and the need to integrate CHWs into the larger health system and provide them with the tools they need to deliver services. She discussed the role of community health committees in creating an enabling environment for CHW performance.
Prof. Miriam Were emphasized the focus has to be on the first level community health worker and this needs to be communicated to medical doctors and nurses in order to improve service delivery.