ARTHUR MWANSA, Chama
THE shortage of health personnel has seen a surge in numbers of community health workers taking an active role in healthcare service delivery.
Community health workers normally offer unpaid labour, but their satisfaction comes from seeing the people they serve getting primary healthcare and living healthy lives.
Charity Mtonga, 37, of Chama district in Muchinga Province has in the last 10-years dedicated her time and energy to providing primary health services to the sick in her community.
Her work involves reaching out to families that have limited access to doctors and nurses and providing them with medical advice on diseases and giving them treatment for simple ailments.
Ms Mtonga also caters for pregnant women and children.
She started her voluntary work as a traditional birth attendant (TBA) in 2007 and she says she has seen a reduction in maternal and child deaths since she and other TBAs started volunteering.
“Since 2007, I have been guiding expectant women in my village about the importance of accessing antenatal care at the health facility. I have also been advising expectant mothers about the importance of giving birth from the health centres,” Ms Mtonga says.
Ms Mtonga, a mother of four, supports her family through small-scale farming. When it’s time to earn bread for her family, she goes to the farm to till the land. In her spare time, she provides a service to the sick in her community. But demanding as health work can be, it usually eats into her time for farming.
Although her labour as a community health worker is unpaid, she is happy to see pregnant women give birth safely and children live healthy lives.
She is among the few community members in Chama district who have been trained to deliver basic health services, but she does not hold any professional health qualification.
Armed with a mobile phone and a bicycle, Ms Mtonga is a life-saver in her community who cycles to far-away places.
Sometimes she has to walk long distances to meet her clients.
“Although I am not paid for the work I do, I am always motivated by the Bible verse in Mathew 7:12 which states that ‘In everything, then, do to others as you would have them do to you’. I can only wish that one day the business community and other well-wishers or even Government will be able to appreciate our efforts and be able to pay us a monthly allowance,” she says.
Ms Mtonga narrates that pregnant women in her catchment area are now adhering to their antiretroviral therapy, while the prevention of mother-to -child transmission (PMTCT) of HIV in Chama district has improved due to the engagement of community health workers.
Kennedy Chavula is another volunteer community health worker who visits patients in the community. He spends one day in a week at Chama community health post conducting health education meetings.
Mr Chavula, 39, has been trained to help the poor in his community overcome barriers to good healthcare in the absence of physicians and nurses.
“I am proud to have been trained as a community health worker. I have since 2000 been encouraging people to seek medical care in health facilities. I am happy to say that I am helping Government to encourage sick people to stick to their treatment,” he said.
Mr Chavula is driven by the passion to serve the needy, and the support from community members and fellow volunteers keeps him going.
For 17 years, he has been making visits to homes of the chronically ill, pregnant women, breastfeeding mothers and individuals at high risk of contracting diseases and giving them the necessary advice.
However, oblivious to what voluntary work entails, Mr Chavula laments about the penniless work.
“Sometimes I feel frustrated as a community health worker because I am unable to meet the basic needs of my family members. We are not paid at all, although some community members think that we are handsomely paid in dollars,” he said.
Since community health workers make daily rounds in homes of patients and 2017sometimes accompany them to the clinic, they understand first-hand the unique health needs of the people.
In an attempt to address the country’s human resource gap in the health sector, the Ministry of Health developed a nation-wide community-based programme called the National Community Health Assistant (CHA) in 2010.
This paved way for the creation of a new group of workers called community health assistants and integrating them into the health system.
According to a 2017 Global Health Action report, evidence suggests that the presence of community health workers can complement an overstretched health workforce and may be key to increasing the availability of, and access to, basic health services, especially in hard-to-reach areas, thereby bridging the health equity gap.
The report also says sustainable remuneration models may be key to long-term job satisfaction, commitment, and retention of community health workers, especially considering the resources invested in selecting, training, and equipping them before they start providing services.
The World Health Organisation (WHO) says adequate compensation improves health worker motivation, retention and performance, adding that fair and consistent wages ensure a stable income and livelihood for community health workers.
Like many other community health workers, Ms Mtonga and Mr Chavula will be motivated if remunerated for their contribution towards a better and healthier Zambia.
Doing so will not only improve their performance, it will also pave way for more community health workers coming on board and meeting their full potential as agents of social change, beyond perhaps their role as health promoters.