As we recognise Universal Health Coverage (UHC) Day 2023, we know that the world is facing many challenges. We are still in the wake of the COVID-19 pandemic, we’ve seen the regression of health outcomes in essential health services, and there’s a growing health workforce crisis. At the same time, many countries have been grappling with how to get back on track and achieve health for all – underpinned at the most basic level by primary care. Strong primary care and emergency response systems will remain a pipe dream without the meaningful inclusion of those most marginalized and excluded from formal health systems. Their inclusion can only be realized by fully integrating community health, and professional CHWs (proCHWs) who are salaried, supplied, supervised and supplied, into formal health systems. Because proCHWs are essential to realizing a first-class health system worldwide.
In recent years, there has been significant progress in rhetoric recognizing the vital role proCHWs can and do play in primary health and health systems resilience. But action must follow this rhetoric. Our proCHW Policy Dashboard shows that only 34 countries have proCHW policies. And at UNGA this year only 12 countries purposefully highlighted CHWs as a core part of their UHC strategy in their statements on the floor. The Monrovia Call to Action – launched at the CHW Symposium – calls on governments to urgently fund, scale, and strengthen community health programs for the realization of health for all and global health security. But action is needed from us all. Together we must:
- Develop clear, costed, and prioritized country-led community health strategies supported by a strong legislative framework that recognize CHWs’ core role in primary health care and global health security.
- Include CHWs, as part of the health workforce, in health sector planning including HRH planning, national disease strategies, implementation, technology, governance, and program monitoring.
- Create pathways for meaningful CHW participation in all decisions that impact them, including primary health and health emergency policy, planning and implementation.
- Align with WHO Guidelines on community health worker programmes by ensuring that CHWs are formalized, paid a fair wage, skilled, supervised, and supplied to deliver the highest quality care, and offered opportunities for career progression.
- Incrementally increase domestic budget allocations for primary health care and CHWs, while decreasing out-of-pocket spending for patients.
- As valued workers, define protections for all health workers, including CHWs, from health risks, violence, and sexual harassment.
At the Coalition we want quality care for all, including those that provide it. That’s why we remain laser-focused on the goal of making proCHWs the norm by changing guidelines, funding, and policy. Because community health workers work, it’s in the name! And they are key to attaining the Sustainable Development Goals and to meeting the interlocking health, humanitarian and climate challenges our world is facing.
It’s time for action.
