Community health workers (CHWs) close the gap between communities and the formal health system. They have a very important role in referral, health promotion and prevention at community level. Their effective involvement leads to significantly better health outcomes in the communities they serve. In short, community health workers save lives. One reason why African countries failed to achieve health related Millennium Development Goals (MDGs) was partly because of the lack of financial and human resources for health, including community health workers.
The current high attrition rate for CHWs is partly because of voluntarism and often involvement in time-bound community health projects. Non-Governmental Organizations (NGOs) often fill gaps to empower communities in remote areas to access health care services. However this is not a sustainable solution for everyone everywhere, particularly when there is no scale up of good practices at the national level, regional and global commitments.
Achieving Universal Health Coverage (UHC) is target 3.8 of the health-related Sustainable Development Goal (SDGs). CHWs play a key role in achieving UHC and realizing the health related SDGs will not be possible without CHWs becoming an integral part of sufficiently resourced health systems in Africa. It is one way governments shall remain accountable in achieving health commitments.
The vision on CHWs should be “Everybody everywhere has access to a Community Health Worker (CHW) for lasting health change”. The discussion now is if this can be achieved with an increased number of CHWs on voluntary basis or with CHWs who are adequately remunerated by governments and supported by defined structure and salary levels upon full integration into the health system.