sirleaf7_ ZOOM DOSSOAFP via Getty Images_nurse liberia ZOOM DOSSO/AFP via Getty Images

Strengthening Africa’s Community Health Programs

In November, the Africa Centers for Disease Control and Prevention launched the first-ever continental coordination mechanism for community health. With this approach, African governments and their partners can build resilient and integrated national programs staffed with professional community health workers.

MONROVIA/ADDIS ABABA – In 2017, African Union heads of state pledged to deploy two million community health workers (CHWs), recognizing their role in advancing health for all. Seven years on, as African leaders prepare to convene in Addis Ababa, we must reflect on our progress. By 2030, Africa will face a shortage of six million health workers, making CHWs a key component and a fast solution to bridging the continent’s health needs. Developing resilient community health-worker programs across Africa has never been more urgent.

We have witnessed how disease outbreaks can plunge a country into darkness – and how the power of CHWs can help pull it back into the light. As Liberia’s experience shows, CHWs need adequate resources and financial support to be effective. In the early 2010s, Liberia’s efforts to offer primary health care in remote areas faced significant challenges. There was a shortage of health workers, and where CHWs were deployed, they were under-compensated and did not have the necessary equipment or training to deliver the essential care that was so desperately needed. As a result, different community health initiatives run in parallel by the government and other stakeholders failed to have a significant impact on patients – a common problem in many African countries.

In 2016, the Liberian government launched the National Community Health Assistant Program to address these issues and apply the lessons learned from the Ebola outbreak that began in 2014. With proper supervision, adequate salaries, and enough supplies to reach every household in their communities, CHWs were empowered to provide standardized, integrated primary health-care services. The results speak for themselves. Liberia’s 4,000 CHWs now deliver nearly 50% of all reported malaria treatments for children under five and consistently provide access to health services, even during the COVID-19 pandemic.

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