A Call for One Million Community Health Workers

by |June 9, 2011

By Anne Liu and Sarah Sullivan

This week the United Nations hosted a high-level meeting recognizing the tremendous gains that have been made in the fight against AIDS and calling for renewed effort to beat the disease 30 years after it was first discovered. But despite the growing momentum over the years in treating and preventing AIDS and other diseases, progress remains slow in addressing the top child and maternal killers in the world — including diarrhea, pneumonia, malaria, malnutrition — all treatable and preventable diseases through low cost innovations.

It is evident that strong political will, civil sector engagement, community awareness, and low-cost technical interventions continue to be crucial but insufficient to achieving the Millennium Development Goals.  Reliable delivery systems for life-saving and sustaining health services are lacking, and utilization of public health systems is considerably low.

Extending the reach of public health systems through a well-trained and supported community health workforce is a key step we can take in meeting the MDGs. This can be done by strengthening health systems and increasing equity in health care access by extending care to the world’s most vulnerable populations.  Providing health care services at the community level, Community Health Workers (CHWs) are internationally recognized for their notable success in averting mortality in newborns and children, and contributing to improvements in maternal and child health. The need to systematically and professionally train CHWs as part of the public health workforce has emerged not simply as a stop-gap measure, but as a core component of health systems strengthening in low-resource settings.

In response to widespread recognition of the need to scale up CHWs as a part of primary health systems in sub-Saharan Africa, the 1 Million Community Health Workers Campaign was launched on May 18th by the Earth Institute, Millennium Promise, UNAIDs, the UN MDG Advocates, the UN Secretary General’s Office, and several pharmaceutical companies to leverage scientific evidence, political energy, and financial will to mobilize at least 1 million CHWs as part of national primary health care systems, in support of the MDGs.

As a part of the campaign, a technical task force chaired by the Earth Institute was commissioned to consolidate decades of scientific and implementation experience surrounding the development of sustainable CHW systems. The document focuses on providing cost guidance and broad operational design and deployment considerations for CHW systems at national scale. The development of this report was a collaborative effort of over 40 technical experts on CHWs from academic institutions, UN agencies, policy makers, and non-governmental organizations.


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