Excellencies, dear colleagues and friends,
Good evening, it’s an honour to be here.
I thank the Susan T. Buffett Foundation for hosting this discussion, and my sister Senait for her leadership, partnership and friendship over so many years.
Senait knows better than anyone the vital role that community workers played in the health system reforms we implemented in Ethiopia when I served as Minister of Health.
As part of a comprehensive health workforce approach, we deployed nearly 40,000 community health workers in every village, trained in hygiene, maternal health, HIV prevention, keeping medical records, immunisation and more.
Globally, WHO estimates there are more than 2.4 million community health workers, the majority of whom are women, in at least 66 countries.
More than 80% of low- and lower-middle-income countries have some form of community health workers, but many do not provide them with a regular salary.
Unfortunately, community health workers often operate at the margins of health systems, without formal employment or being compensated for the crucial roles they play.
In fact, community health programmes more than pay for themselves with dividends in population health, rural development, job creation and women’s employment.
Making community health workers a sustainable part of a strong health system means integrating and supporting them as part of national and international investments in the overall health workforce, rather than as a siloed programme.
In recent years, more countries, from Brazil to Bangladesh and Liberia, have taken concrete steps to integrate community health workers into their health systems and improve the way they are selected, educated, deployed, supervised and paid.
We need to build on this momentum in three key areas:
First, we must provide community health workers with fair and equal pay, with respect for basic labour rights.
Second, formalizing the status of community health workers requires long-term, dedicated domestic financing, supplemented by international financing where needed.
Countries have demonstrated that it is possible to make sustainable investments in large-scale community health worker programmes, and WHO has issued guidance on the best way to integrate them in health systems.
We urge development partners and external funders to harmonize their support, to include the recurrent cost of wages, rather than ad-hoc payments such as per diems or incentives.
And third, it is important that community health worker programmes are integrated into national health systems, policies and investments, aligned with gender, equity and social inclusion principles.
WHO’s Working for Health Action Plan to 2030, and the Global Health and Care Worker Compact, provide an overarching platform to assist countries in this integration.
WHO stands ready to support governments and their Ministers of Health.
We have a shared duty to protect and invest in community health workers – and all health workers – just as they care for us.
I thank you.