A critical shortage of health workers remains a significant challenge to achieving universal health coverage and reducing under-five and maternal mortality. In order to achieve Sustainable Development Goal 3 - to ensure healthy lives and promote well-being for all at all ages - urgent action is needed to address the PHC access crisis.
As such, the WHO is advocating for the adoption and expansion of CHW programs, alongside the expansion of programs to train doctors and nurses and place them in geographies where they can serve vulnerable populations.
In 2018, the WHO released guidelines to optimize program design and implementation to help expedite the adaptation and adoption of effective CHW programming. In response to the new guidelines, during the May 2019 World Health Assembly, member states supported a resolution recognizing community health workers as key health system components in providing primary health care services.
“I think we all share the belief that the key to universal health coverage is to involve and grow the health care team. Community health workers should stand side-by-side with nurses and doctors to extend primary health care to every last child and family on earth.”
- Jim Campbell, WHO Health Workforce Director1
Number of CHWs
Current estimates indicate there are more than five million CHWs around the world, including approximately 2.3 million in India, alone. Still, there are large swaths of the globe where there is significant unmet need for primary health care and growing support for the wider implementation of CHW programming to meet those needs.
Discussions on the implementation and expansion of CHW programming have been particularly robust in sub-Saharan Africa. It is in this geography that CHWs have been identified as a potentially critical tool for managing the HIV/AIDS epidemic. And it was during West Africa’s Ebola epidemic in 2014 that policymakers and other stakeholders recognized the potential for CHWs to play a key role in strengthening primary health care systems and building resilience against future infectious disease outbreaks.
In 2017, African Union leaders endorsed a plan to mobilize another two million professional CHWs by 2020, to address a projected gap of nearly 1.1 million doctors by 2030. The plan recognizes that CHWs cannot replace doctors or nurses, but maintains that CHWs can help manage HIV and TB cases, reduce transmission of both, improve the delivery of primary care, and help countries achieve the Sustainable Development Goals.
“Few, if any, of our health and development tools match the potential of community health workers to drive gains on multiple fronts. A substantial body of evidence demonstrates that community health workers increase uptake of health services, reduce health inequalities, provide a high quality of services and improve overall health outcomes…”
- African Union’s “2 million African community health workers: Harnessing the demographic dividend, ending AIDS and ensuring sustainable health for all in Africa”.
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1
Momentum for community health workers at the Seventy-second World Health Assembly. World Health Organization (WHO) website. https://www.who.int/hrh/news/2019/health-worker-momentum-wha72/en/. Published May 22, 2019. Accessed November 5, 2019.