Posted on: March 4, 2025
Sub-Saharan Africa faces a $4.4 billion funding gap for community health programs. The current reliance on donor funding, often fragmented, makes it challenging to build strong and effective community health systems.
Some countries are finding innovative solutions. Malawi has adopted a “one plan, one budget” approach. This strategy aligns all health programs and initiatives under a single strategic plan with a unified budget. The goal? To streamline resource allocation and improve coordination between different health actors, including government agencies and donor partners.
In Kenya, organizations like Living Goods are partnering with county governments in Kisumu, Busia, and Vihiga to strengthen community health systems. Their co-financing model is based on the idea that sustainable health outcomes are best achieved when governments take the lead in health programs.
At the sidelines of the Africa Health Agenda International Conference, in Kigali, Living Goods and partners Africa Frontline First, Village Reach, and UNICEF converged to look into long term financing solutions.
Christine Namayanja, Living Goods’ Country Director in Uganda emphasized the importance of domestic funding:
“A strong healthcare system needs consistent and adequate domestic funding. Many African countries struggle with this, with less than 15% of their national budgets going towards health. With changes in foreign aid, African nations need to develop sustainable financing strategies for community health.”
Joan Amambia, a community health worker (CHW) from Kenya shares her perspective:
“When I started as a CHW, we worked as volunteers. Now with government and partner support, things have improved,” she said, adding: “We have smartphones with digital systems, training, supplies, and tools. Supervisors monitor and coach us to improve our work, and we receive regular stipends. But with global changes in funding health, I worry we might lose these gains.”
UNICEF Country Representative, Ms. Lieke, highlighted another crucial issue:
“The gendered funding gap in community health affects female CHWs through unequal pay, limited career growth, and insufficient workplace protections. These issues create barriers for women in the workforce. Addressing this gap is essential for a fair and effective community health system.”
In short, CHWs are the backbone of many healthcare systems, especially in Africa. But they need our support to keep doing their vital work. We can’t just talk about it; we need to act.
Dr. Addis Tamire from Amref Health Africa puts it well. He’s calling on everyone – governments, funders, partners, and stakeholders to step up.
“It’s time to fully integrate CHW programs into national health budgets. This isn’t just a nice idea, it’s essential for long-term success. We need to put our money where our mouth is. That means increasing funding for community health workers through national budgets,” said Dr Tamire. He added, “But it’s not just about throwing money at the problem. We also need to get innovative with how we fund these programs. By identifying and implementing innovative and stable ways to finance CHWs, we can ensure they’ll be there for communities for years to come.”
These insights show the complex challenges and potential solutions in funding community health in Africa. As countries and organizations work towards sustainable and equitable models, the focus remains on improving health outcomes for all.
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