Newsroom & Blog

Apr 4, 2023   |   Blog Post

Fresh impetus for community health worker empowerment at CHW2023

By Tom Foot

Communications Manager

“The moment before us is too important for us not to act now.” Former Liberian president, Her Excellency Ellen Johnson Sirleaf, opened the 3rd International Community Health Worker (CHW) Symposium 2023 with a clarion call to recognize the current and potential contributions of CHWs to improving health care delivery to reach everyone.

It was a call that resonated across the room and was felt deeply by over 1000 delegates from 49 countries, including top-level government officials, delivery organizations, and, of course, CHWs themselves who gathered in Monrovia, Liberia, from around the world to share knowledge and best practices on how to scale and sustain community health programs.

The theme of the late March symposium was “Advancing Community Health Worker programs to build resilient and equitable health systems that accelerate Primary Health Care for Universal Health Coverage.”

No conversations about CHWs, without CHWs

The symposium featured invigorating keynote addresses from Liberian President Dr. George Weah and Director-General of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus, as well as panel discussions on the role of CHWs in the COVID-19 pandemic, the use of technology to support community health programs, and the importance of gender equality in community health.

But what marked this symposium as a special “moment,” as Her Excellency Ellen Johnson Sirleaf remarked, was the elevation of the voices of CHWs as never before, setting the stage for future conversations by embodying the principle “nothing about CHWs, without CHWs.”

Community Health Impact Coalition members deserve a special mention for their tireless energy and united effort to get health workers to this conference and onto the stage on nearly every panel, providing CHWs the space to advocate for themselves.

VillageReach sent eight delegates to the conference to showcase our leadership in supply chain optimization and product availability for CHWs, share the efficacy of our work leveraging CHWs to increase immunization demand, build momentum around our research and advocacy for empowering CHWs as vaccinators, and to learn from and connect with others.

What did we learn?

The symposium helped raise the profile of CHWs and their essential role in providing health care to communities worldwide.

Here are some key takeaways from the symposium:

  • CHWs play a vital role in delivering preventive and curative services and providing social and emotional support to their communities.
  • CHWs are often the first point of contact for people needing health care. They are able to provide care in a culturally appropriate and accessible way, and they often play a key role in building trust and rapport with their communities.
  • CHWs are a cost-effective way to deliver health care. They can reach large numbers of people with limited resources and help improve the health outcomes of communities.

“Not Only a Health Issue, But a Human Rights Issue”

In her opening address, Her Excellency Ellen Johnson Sirleaf also noted that CHW pay and conditions are “not only a health issue but a human rights issue, and this message was reinforced throughout the superseding three days. We were deeply encouraged to hear CHW advocates and others amplify the importance of supply chain management for CHWs repeatedly. It was impossible to attend the symposium and not hear the consensus call for CHWs to be salaried, skilled, supervised and supplied.

As Cameroon CHW Anjah Lilian Nchogwe noted, “What they [currently] give us is only good for motivation, but we need payment.”

We need health supply chain systems that activate and optimize for CHWs so that they can deliver quality health care for their communities, no matter how remote or traditionally under-served. Without this important cadre, universal health coverage is not achievable.

“CHWs are the basement of the health structure. If the structure has gaps and cracks, the system collapses,” said Margaret Odera, a CHW from Kenya.

CHW supply chains were a key point of discussion across the symposium, underscoring the importance of digital systems to collect and report CHW supply data, the urgency to include CHW product needs into national forecasting processes, and ultimately that CHW supply chains cannot be an afterthought.

Advancing CHW programs

So, what next for Advancing Community Health Worker programs to build resilient and equitable health systems that accelerate Primary Health Care for Universal Health Coverage?

The symposium was a valuable opportunity to learn about the latest research and best practices in community health. But it was more than this. The diversity of the delegations, including policymakers from across the world, and different sectors presented fresh opportunities for multisectoral consensus-building and ongoing collaboration.

The symposium produced the Monrovia Declaration, which calls on countries to invest in domestic community health strategies, professionalize CHWs, integrate CHWs into health care planning and track the progress of CHW programs.

Indeed, the Liberian government was not only a gracious host but a first mover, ensuring advocacy for CHWs to be salaried, supported and supplied, and work like VillageReach’s Supply Chains for CHWs program can progress with fresh hope and renewed impetus immediately following the symposium’s call to action with a surprise announcement of new funds to professionalize the country’s CHW workforce.

Her Excellency Ellen Johnson Sirleaf finished her address by saying that we can’t keep asking CHWs to respond first if we continue to put them last. This summit was an essential step in addressing that glaring asymmetry.

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