In rural communities around the world, community health workers (CHWs) have long been trusted providers of healthcare. Every day, CHWs cover long distances to make sure that all their neighbours – even the most remote – have access to health services. On this International Day of Rural Women, we celebrate the care CHWs provide for their communities, while recognizing that the world has not always cared for them.
Estimates suggest that of the 3.3 million CHWs working globally, 70% are women. Despite their critical role connecting communities to care, only 14% of CHWs in Africa are remunerated, with millions more serving as volunteers who are poorly supported with little to no compensation. In Kenya, the community health workforce, which is the backbone of primary care, is largely composed of women, the majority of whom do not have supportive supervision, consistent training, or salaries. There is a dire need for stronger CHW programmes across the country that professionalise CHWs, empower and support them to reach their full potential.
Lwala Community Alliance and Medic are part of a global movement to professionalise CHWs – ensuring they are paid, trained, supervised, and digitally enabled. CHWs play a pivotal role in caring for their communities. CHWs are an essential component of the health system, especially in enhancing access to healthcare in rural and remote areas. They are trusted by their community members to provide critical health services that reduce the burden on health facility staff and referrals. We believe that when CHWs are professionalized, they are able to unlock opportunities for better and more accessible health services – accelerating advancements toward universal health coverage. Lwala also incorporates traditional birth attendants into professionalised CHW cadres, recognizing that their expertise has long been left out of the formal health system.
Medic builds, deploys, and supports open source software that helps CHWs, their supervisors, and facility-based teams work together to provide quality, timely, and equitable care.. We work alongside governments and other implementing and technical partners to support efforts to reimagine and professionalise CHW programs, demonstrate evidence of their impact on health outcomes, and leverage digital health innovations for frontline health worker motivation, retention, performance management, continued education, and career advancement.
Digital tools empower CHWs, make their work and progress visible, and increase the confidence of policymakers in the quality of care being delivered allowing for increased advocacy for professionalisation. Digitization of Lwala’s 400 CHWs has led to increased performance and enabled them to extend high-quality care to every home. Lwala’s digitally empowered community health workers track individual health outcomes and receive real-time decision-support. Paired with rigorous research and evaluation, this data enables Lwala and government policymakers to make evidence-based decisions.
Together, we are committed to putting CHWs at the centre of our programs and digital tools, leveraging human centred design to co-create potential solutions and test the developed solutions to ensure that they meet the needs of CHWs and the communities they serve. This transformative approach tackles the growing challenges of the digital health community and serves as a guide into understanding local context thus shaping the implementation, institutionalization, and scale up of digital health across the world. Learnings from our collaborative work in Kenya builds upon the more than 120 digital community health initiatives supported by Medic and the CHT over the last decade. In partnership, we are committed to bringing lessons and best practices back to our global open-source community of practice.
Medic and Lwala continue to advocate for the investment and use of digital tools to build the capacity and skills of CHWs, thus increasing long term local sustainability and equity of care. As we celebrate the International Day of Rural Women, we recognize and honour the pivotal role of community health workers in keeping their communities safe and healthy.