Agents for Empowerment: Community Health Workers Deliver

Next week, I will join the thousands of heads of state, ministers, thought-leaders, technical experts, civil society organizations, young people, community leaders, and many others in Nairobi for the 25th anniversary of the International Conference on Population and Development (ICPD). At this conference in November 1994, 179 governments adopted a Programme of Action recognizing that reproductive health, women’s empowerment, and gender equality are the pathway to sustainable development. Progress has been made in implementing this ambitious plan, but we still have a long way to go.

More than 200 million women still lack access to modern family planning and an estimated 830 women die in childbirth every day—many of them girls aged 15 to 19. In order to reach these women, it is imperative to include sexual and reproductive health and family planning services as an integral part of universal health coverage (UHC) and explore innovative ways to deliver these services, including through investing in community health programs at large.

Community health programs provide a high-impact, low-cost solution to common health system challenges faced in low- and middle-income communities, reducing inequities in access to care. By integrating comprehensive family planning services into existing networks of trusted community health workers (CHWs), major barriers to reproductive health services—including fear, social opposition and misinformation about side-effects—can be addressed. Such integration can also increase agency and equity, ultimately bolstering sustainable growth.

I have seen the power of CHWs firsthand in Uganda where Living Goods supports CHWs to provide comprehensive family planning services, including two types of daily birth control pills, condoms, and referrals for longer-term and permanent methods. Additionally, CHWs supported by Living Goods provide client-centered counseling approaches in which CHWs customize messages to the needs of individual women and their reproductive goals.

One Living Goods-supported CHW, Nakiwala Teddy, explained why she is effective at delivering services,

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