CHW Central: 2018 – The Year of Primary Health Care

4 February, 2019

By: Kingsley Chikaphupha, Reach Trust (Malawi) and co-chair of the TWG on CHWs, and Maryse Kok, KIT Royal Tropical Institute (The Netherlands)

Extracts below. Full text here:


'Forty years after Alma Ata, 2018 was a remarkable year regarding the promotion of health for all. The Global Conference on Primary Health Care, co-hosted by the government of Kazakhstan, WHO and UNICEF, was held in Astana, Kazakhstan on October 25 and 26. A new declaration on primary health care, aligned with the sustainable developments goals, was made. During the same conference, WHO launched a new guideline on health policy and system support to optimize community health workers programmes. Health Systems Global (HSG) also held its 5th Global Symposium on Health Systems Research in Liverpool, UK in October 2018. Common across all these events was the call that the provision of universal primary health care should be at the heart of sustainable health systems.

During the 5th HSG symposium, the network’s thematic working group on supporting and strengthening the role of community health workers in health system development (in short, the HSG CHW TWG) organized a participatory session to share experiences from CHW research and practice, to strengthen leadership and management of CHW programmes across the globe...

Discussions centered around five themes: 1) CHWs’ roles in responding to new health challenges – aging and non-communicable diseases; 2) the optimization of CHWs’ intermediary role between health systems and communities; 3) challenges in supporting CHWs to promote quality services; 4) CHWs in fragile or conflict-affected contexts; and 5) knowledge transmission and scale-up of CHW pilot studies and programmes...

Hereby, we should commit to consider the question that was raised during our session in the HSG symposium: How can we work to move from asking what CHWs can do for the health system, to engage them with the unique perspectives they bring and also ask how can we support CHWs?...


Comment (NPW): Indeed this question is fundamental. HIFA is currently underrepresented by CHWs themselves and we welcome more to join us on HIFA (English), HIFA-French,. HIFA-Spanish and HIFA-Portuguese. We have had some success to give CHWs a voice on HIFA via country- or district-level WhatsApp groups in the local language, facilitated by HIFA CHW working group members. How can HIFA (and others) do more? There has also been discussion around the formation of CHW associations/trade unions to give CHWs more of a voice at country and global levels. The question of "how can we support CHWs" is also fundamental, and the question raised by the TWG demonstrates that it has hitherto been neglected (it should of course have been a fundamental question right from the start). The recent WHO guideline on health policy and system support to optimize community health worker programmes [ suggests some answers.

Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: