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,

My service toward women seeking family planning services is different because in the past, women used to go to public hospitals that are quite far. But when I start working as a community health worker, they come to me who is closer to them hence cutting off the long distance.”

 

Additionally, a CHW in Iganga District, Uganda recently shared with me the impact of her services on materials and child health:

 

I previously had a neighbour with sick children and the family could not afford treatment and the public hospital was often out of stock of medicines and is far away from their home. Because of this community health work, I have been able to provide services to my neighbour because our services are low cost and affordable for most villagers.

Additionally, the benefits of community health go beyond improved health outcomes. If adequately funded, community health can help promote gender equality by offering women qualified employment opportunities, education, and autonomy. This increases the chances of improved family education, nutrition, women’s and children’s health, and more.

This is why Living Goods is committed to increasing the number of supported CHWs in both Uganda and Kenya to deliver family planning services and register, monitor, and support pregnancies; flag risk factors; and ensure pregnant women attend all antenatal care clinic visits and give birth in a health facility. As we come together in Nairobi, we must acknowledge that without universal access to family planning and reproductive health services, women’s empowerment, and gender equality cannot be achieved.

Written by

Edward Zzimbe

Deputy Country Director, Direct Operations

Edward Zzimbe is a private sector and health markets expert with local and international programmes experience. He is currently the Deputy Country Director of Direct Operations for Living Goods in Uganda. He has successfully designed and managed several large and innovative donor-funded programmes for DFID, USAID, Bill & Melinda Gates Foundation, UNFPA, UNDP, the World Bank and the German Development Bank (KfW). He has an exceptional track record in delivering results and has previously served as the Technical Director & deputy to the team leader for DFID Kenya’s flagship family planning. He is an expert in external relations including working with governments, New business development, public relations and has represented Africa at the House of Commons (UK) and European Parliament (Brussels).  

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