Community health workers are often the best – and only – resource for people living in rural and remote areas. Support for community health workers contributes to strong, resilient health systems that can reach more people with lifesaving health care.
Since 2020, the Global Fund has invested over US$1.5 billion in community health workers in more than 100 countries and is investing US$900 million more over the next three years.
We are talking to community health workers about the challenges and impact of their vital work.
Why did you decide to become a community health worker?
I was 27 when I decided to become a community health worker. When I was smaller, I fell ill and almost died. And it affected my family a lot. When I was a bit older, the chief of my community launched a community health training, and I seized the opportunity. I committed to it, body and soul.
For me, it’s not just a job. It’s become a passion. I made a real commitment to educate people, to help them realize that these diseases can make you and your family ill, that they can hurt you, and that you can protect yourself.
Describe a typical workday.
I’m a community health worker for the Nkolbisson district and for the Shemka Foundation in Yaoundé, Cameroon. We go door to door in the field to get in touch with our people, to get in touch with our communities. We see the problems the community is experiencing. Then we do educational talks based on what we find.
So, for example, when I arrive in a community and I hear that children don’t know how to avoid malaria, I tell them how they can protect themselves.
But we’re not there just for malaria. We’re there for HIV, tuberculosis and other types of care. We help mothers who want to vaccinate their children. We give them advice about breastfeeding and family planning. We teach them how to properly install a mosquito net.
And I do home visits. Home visits allow us to make contact with the family. We see what the household is going through, so we are in a better position to provide advice. I don’t give advice blindly.
We also do disease and epidemiological surveillance – for example, keeping track of the number of cases of yellow fever, cholera and measles. We really do have a lot of responsibilities.
What is your role in the community?
My job is in the field, working to raise public awareness. That’s really our role as community health workers. Take malaria, for example: We help people realize that malaria is a disease caused by a mosquito bite, which leads to fevers and pain. We make them aware of that and try to keep people healthy.
Community health workers have to be good listeners – we listen to our patients. We have to be of good character, be empathetic and know how to put ourselves in the other person’s shoes.
It’s not always easy. Sometimes the first contact with a family doesn’t work. You try a second time, you try a third time, until the household accepts you. And when they do, you listen to them. You put yourself in their shoes. And from there, you’re in a better position to give advice.
I also draw on my personal experiences and tell people about what I’ve experienced. That helps them to trust me.
What are the biggest challenges you face?
First of all, we cover vast areas, and traveling long distances can be difficult. On top of that, there aren’t enough of us. Sometimes our pay is delayed, or we don’t get paid at all. Stock-outs are also a big problem – sometimes, we are asked to buy medicines ourselves.
We also need visibility and legal recognition. I’m really exposed as a community health worker because I don’t have a contract, a shield, to protect me. So I’m working in the dark.
It is really important for us to be paid and recognized, with legal protection, to do our work.
Beyond my role as a community health worker, I try to be a strong voice to defend my community’s interests. I participate in programs such as Impact Santé Afrique’s (ISA) Voix de la Lutte – and want to thank ISA for its constant support. Through ISA, I want to reach the people who have the power to make decisions.
What are your hopes for the future?
The vulnerable families in our communities really need help. If they don’t have community health workers, what kind of future will they have? How will they cope?
There was a child in my community who died. We explained to the mother that it was malaria, but by the time the child was transferred to the hospital for treatment it was too late. I was really affected by it – it was really sad for me.
But there are also happy stories. Sometimes children recognize me when I’m walking down the street: “Hey, there’s the aunt who came to look after me.” And moms see me and say, “Since you were last here, my child is starting to talk,” or “My child is going to study.” Because we don’t talk only about illness – we talk about humanity.
What feels good, what makes me realize that we’re having an impact, is that at some point, people start to change. They take action; they change their behavior.
They know what to do when a child is sick. The first thing they do is call us.
With many thanks to Impact Santé Afrique.