West Africa Regional Health Leaders Call for Full Integration of CHWs into Health Systems to Advance Universal Health Coverage
Government and civil society health leaders from nine Francophone countries of West Africa called for the integration of community health workers (CHWs) into their nations’ health systems at a ground-breaking meeting in Lomé, Togo. An agreement calling for formalization of the health cadre was developed by health officials and partner implementer delegates with input from colleagues from the World Health Organization, the West Africa Health Organization, UNFPA, and USAID’s West Africa Regional Office. The formal agreement was agreed to unanimously and announced at the closing session of the “Advancing Universal Health Coverage: Community Health Workers, An Essential Link” meeting.
The agreement calls for country delegations to host follow up meetings in each Francophone country to devise national action plans by June 30, 2020, with the goal to mobilize political will and financial support for the inclusion of CHWs in their respective health systems. It also calls on the support of regional health bodies to support advocacy for regional policies and guidelines to support the effort.
Meeting delegates from Benin, Burkina Faso, Cote d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal, and Togo pledged to take up the recommendations with their respective Ministries of Health to ensure the momentum on the initiative continues. In many countries, CHWs have been mobilized by externally funded initiatives that focus on specific health area interventions and are limited by donor funding and time-limited presence in the country. The move for formalization will ensure continuity of this essential workforce and open the door for integrated service delivery and task sharing.
The meeting, held from September 16–19 in Lomé, Togo, kicked off at an opening ceremony with Cabinet Director of the Minister of Health and Public Hygiene, Madame Akakpo Midamégbé; U.S. Ambassador, Eric Stromayer; Dr. Keita Namoudou of the West African Health Organization; Dr. Diallo Fatoumata Binta Tidjane, the representative of WHO in Togo; and Barbara Rieckhoff of Health Policy Plus. Eleonore Rabelahasa, the Senior Health Systems Strengthening and Policy Advisor in USAID’s regional health office in Accra, also participated in the meeting. The three-day meeting gathered health officials and implementing partners and included Malian mayor, Yacouba Traore, whose municipality funds CHWs.
Also joining were five Togolese CHWs, who relayed their experiences in carrying out their day-to-day efforts, including obstacles that they recommend be addressed. The CHWs, who deliver a range of family planning, malaria and health consultations, discussed the challenges and opportunities they face as front-line health workers and their perspectives to improve their capacity to improve equitable access to health services. One remarked, “The remunerations should really be revised and steadily provided to ensure sustainability. Furthermore, the government should put in place a financing strategy guaranteeing support to community health services.”
The meeting featured a costing analysis from Mali, where the government subsequently announced formalization of CHWs into the formal health system. The meeting was organized by Health Policy Plus West Africa, with funding support from USAID West Africa. The Ouagadougou Partnership supported delegates from Mauritania and Senegal to attend and UNFPA Guinea supported the participation of the Guinea delegates.
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