Analysis: DOREEN NAWA
THE use of community health workers in various public health facilities has been identified as one strategy to address the growing shortage of health workers, particularly in low-income countries like Zambia.
Using community members to render certain basic health services to communities they come from is a concept that has been in existence over the past years.
It is against this background that Ministry of Health feels a need to celebrate these unsung heroes that are handy to Zambia’s attainment of the global target of achieving universal health coverage.
Globally, as Zambia joins the rest of the world in commemorating the World Health Worker Week, which runs from April 1 to 7, Ministry of Health spokesperson Maximilian Bweupe notes that community health workers are important, especially in rural areas where health services are limited and, particularly, services that offer culturally competent care.
Dr Bweupe feels that as the week is being commemorated, it is important to acknowledge the work that community health workers, commonly known in Zambia as community health assistants, do and celebrate them.
He explained that community-based strategies have become an integral part of maternal and child health, malaria, and HIV/AIDS programmes countrywide, and community health workers have become an important tool in delivering such services.
Amid numerous challenges, community health workers provide a service in rural areas and work to improve healthcare outcomes by facilitating healthcare access, adding value to the healthcare team, and enriching the quality of life for people who are poor, underserved and in diverse communities.
They act as a liaison between providers and consumers within rural communities.
Dr Bweupe explained that some of the services community health workers provide include culturally appropriate health and prevention education, referrals for a wide range of health and social services, assistance in navigating the health services system, and in co-ordinating care.
Other services are advocating for the individuals and communities within the health service system, translation and interpretation of services, and indeed provision of basic health screening tests.
Often, community health workers speak the same language, share the same ethnicity and are of the same socio-economic status as the rural clients they serve.
While community health workers have traditionally been used to work with minority populations, the use of them has greatly increased in recent years so that they now serve a wide variety of rural and underserved populations.
That is why Government has over 2,000 trained community health assistants who provide a wide range of care-related services in communities.
The training came as a result of a policy decision by Government, through the Ministry of Health.
In line with the policy, to qualify as a community health worker, one must have completed secondary education and must then be trained for a year after going through practicals.
Currently, there are two training institutions for community health workers in Zambia – Mwachisompola and Ndola.
And once they graduate, the community health workers are certified and put on payroll.
The question of remuneration for community health assistants in Zambia and other low income countries remains contentious.
Luckily, for Zambia something is being done.
In most low income countries, community health workers get motivation through incentives in monetary and non-monetary form, in most cases.
However, there is enough evidence that volunteerism has contributed to demotivating the community health workers worldwide.
Additionally, fair and consistent wages ensure a stable income and livelihood for community health workers.
It is a well-known fact that without improvement to the human resources situation in the health sector, the health-related sustainable development goals cannot be achieved.
In Zambia, community health workers are an important resource in health delivery in rural areas as well as densely populated townships in major cities in the country. Community health workers fulfil a significant role in improving access to healthcare for the poor.
They create a link between the health system and communities. They also have the potential to improve access to sectors, other than health, creating avenues to services such as social welfare and housing.
The community health workers provide a wide range of care-related services, which include conducting health promotion activities such as awareness about diseases as well as identifying and attending to minor ailments.
The success of the efforts has caused not only Government agencies, but also non-profit organisations like AMREF Health Zambia, to advocate the elimination of persistent disparities in healthcare delivery in underprivileged communities.
Looking at their significance, community health workers can have more impact if they are formally incorporated into the health workforce as a way of recognising and understanding their unique needs.
Health human resource requires diverse and comprehensive skills to provide integrated, people-centred services for all.
Community health workers, therefore, need to be safe and well-supported on the job.
Because community health workers count and are a precious resource, they must be managed well by taking evidence-based approaches to optimise their allocation.
Much more, building the capacity of community health workers to reach underserved populations is a sure way of increasing access to quality healthcare.
Certainly, community health workers count.
The author is a Zambia Daily Mail reporter.
Analysis: DOREEN NAWA