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Zambia’s National Community Health Worker Strategy

Author: Ministry of Health (MoH)
Country: Zambia

MoH, Zambia

CHW promoting Child Health Week- encouraging families to bring their children to the Health Centre for vaccinations, weighing/malnutrition testing, etc. This is one of the many tasks CHWs do today and will continue to do in the future.

Challenges

Zambia has critical human resources for health (HRH) shortages, leaving much of the rural population with inadequate access to health services as shown in figure 1 below. To combat the shortages several non-government bodies have trained informal workers as Community Health Volunteers (currently estimated at 23,500 in Zambia) to tackle disease specific issues. However, it was recognized that these volunteers had no formalized training, insufficient oversight, and were not truly captured as part of the health system. The Government decided to maximize the effectiveness of this informal cadre of health workers in Zambia through a National Community Health Worker (CHW) Strategy.

Disparity in Urban-Rural Distribution of Clinical Health Care Workers: Number per 1,000 people

Policy description

The strategy was developed to formalize and standardize the role of CHWs in the health sector in order to enable equity of access to high-impact primary health services.

The Ministry of Health (MoH) conducted an extensive, national situational analysis and embarked on a collaborative planning process. The analysis produced 6 main findings on: the relationship between national health system and CHWs, recruitment of CHWs, training of CHWs, employment of CHWs, Supervision of CHWs and finally the monitoring and evaluation framework of CHWs. The MoH lead team also conducted research visits and investigations into CHW programs in a range of countries including Ethiopia, Malawi and Uganda, in order to learn from their experiences. To implement the Strategy, MoH will conduct a pilot with 330 CHWs, commencing in 2010.

Outcomes

To date the process has resulted in:

• Coordination of community health activities between MoH and implementing partners
• Acceptance by the statutory bodies to register and legally oversee CHWs
• Acceptance by the health unions
• Financial support from both the Government and stakeholders
• Processes put in-place to ensure financial absorption by the Government
• Effective utilization of existing resources

Conclusions

Zambia is positioned to achieve its overarching CHW Strategy goal to have a cost‐effective, adequately trained and motivated community‐based health workforce that will contribute to improved management of common and preventable health conditions in Zambia.