The Need For Community Health Workers

Why are community health workers needed? Because there simply aren't enough highly trained medical personnel, like doctors and nurses, to meet the health needs of everyone living in sub-Saharan Africa, including Ghana. Several factors are at work to create this deficiency. Medical training is long and expensive and medical training centers can't keep up with the demand, especially as populations grow. Many trained medical professionals prefer to work in the cities or to seek work in other countries where the pay is better. Furthermore, AIDS and other diseases have stripped the medical community of valuable workers.

Many of the previous blogs make mention of the Millennium Development Goals, which address the most pressing human development needs around the globe. Of the eight goals, three aim to improve human health by reducing child mortality (MDG 4) and maternal mortality (MDG 5), and by combating HIV/AIDS, malaria, and other diseases (MDG 6).

Ghana has serious needs in all of these areas, but never more so than for people living in rural areas, who may have quite a distance to go to receive any kind of professional medical attention and may be impossibly far from the nearest hospital. In many cases they are also too poor to pay for expensive medical services and medicines. On top of this, they may be fearful or mistrustful of leaving their homes and being attended by clinic workers they don't know.

One way to improve their access to basic health care is to provide the services of community health workers (CHW). A CHW is an individual from the community who is rudimentarily trained to provide basic health services, mainly to those who are under-served. Their services may include prenatal visits, post-natal mother and infant care, vaccinations, counselling on sexually transmitted diseases, and specialized programs like malaria and tuberculosis prevention.

The person may be a volunteer or may be paid a salary for their work. The advantage in having a local person fill this role is that they know the local customs and language, and are more likely to be accepted by the community than an outsider of the same standing. CHWs usually maintain their ties within their community and, with proper support, tend to stay with the job.  The people they serve typically trust them, and the CHWs have a respected standing in the community.

Through their provision of primary health care, CHWs contribute valuably to the whole community, but they are particularly important in improving the health of children. In the case of Humjibre and the surrounding communities, CHWs have been involved in every step of our malaria prevention programs, and their dedication has led to a marked rise in the ownership and use of insecticide-treated bednets.

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Sources

Global Health Workforce Alliance. 2010. Community Health Workers - Key Messages. http://www.who.int/workforcealliance/knowledge/resources/chwkeymessages/en/index.html

Lehmann, Uta and David Sanders. 2007. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. School of Public Health

University of the Western Cape. Report for the World Health Organization, Geneva.

Morrow, R.H. 1983. A primary health care strategy for Ghana. pp. 272-299 in Morley, D., J.E. Rohde, and G. Williams (eds.) Practising Health for All. Oxford University Press: Oxford. 272–299.