World Health Assembly 76.
The Coalition was in attendance at World Health Assembly 76 advocating for the professional CHW (proCHW) movement.
The Good
Global recognition of proCHWs within UHC.
Our movement successfully pushed for the inclusion of five of eight proCHW best practices in the Political Declaration on UHC. The Declaration provides commitments for proCHWs to be accredited, continuously trained, and paid (Operative Clauses 92, 93, 95). It also commits to a participatory approach to health systems design. And to the minimization of out-of-pocket payments (Operative Clauses 46b, 50, 104). These wins provide a strong foundation to push for greater investment in proCHWs at country level.
ProCHW language everywhere.
From side events to the floors on the High-Level Meetings, we noticed many stakeholders talking about proCHWs. This is the holy grail of advocacy – to have our position fully incorporated by those who we seek to influence. And it shows how clear, consistent, and effective our collective advocacy has been to date.
The bad.
Weak language on CHW integration.
While the centrality of community health in UHC and PPR was recognized, language on CHW integration into formal health systems was consistently weak within the UN official processes. There was no mention of the need for supportive supervision to carry out their roles. And the role of proCHWs in disease surveillance and data feedback loops was largely ignored. Now more than ever, we have a formidable fight ahead of us to shift the hearts and minds of global health leaders on CHW integration to ensure all eight proCHW best practices are addressed at the highest level of political discourse.
Inadequate commitments to systematically supply CHWs.
Political Declaration on PPR hinted at the need to supply proCHWs during health emergencies (Operative Clause 48), this requirement was not explicitly mentioned in either Political Declaration. Here’s the reality – CHWs experience stock-outs 29% of “ordinary” times compared to their affiliated health centers, which are impacted 9% of the time. Without purposeful and consistent investment in supplying CHWs, our health systems are likely to fail in ordinary and emergency times.
The opportunity
Growing synergies between proCHWs and other movements.
UNGA 78 had many side events focusing on areas that intersect with community health and proCHWs. From climate change; to HIV, malaria and TB; to other health workforce groups, movements with which we have much in common gathered to affirm their priorities. As momentum builds for proCHWs, we can and should do better in our outreach to other movements – including some nontraditional allies – to ensure uptake of our core advocacy messages and advance quality care for all.
Translating proCHW policy into UHC policy.
Our proCHW Policy Dashboard shows that 34 countries have proCHW policies. Yet, only 12 countries purposefully highlighted CHWs as a core part of their UHC and PPR strategy in their statements on the floor of the High-Level Meetings. We’re not only pushing for all countries to enact proCHW policies, but also for those proCHW policies to be integrated into primary health care and health for all.
RESOURCE LIBRARY
The Founding Story of CHIC: Creating a New Movement.
How as a Coalition we’re transforming the community health landscape.
CHW Advocates are seizing power.
For too long, discussions about community health workers (CHWs) have been happening without CHWs in the room. It’s time for a change. Community health workers are seizing power.