CHWs (3) What are your thoughts on the new CHW Guideline? What questions do you have about it? (2)

2 June, 2019

I am new to this forum and I'm glad that the first issue am seeing under discussion is the CHW guidelines []. Having served in the public service and private as well, the relevance of the guidelines couldn't have come at a better time than now when the world Community is advocating for universal health care and the SDG 3.

I personally feel if adopted by nations, the guidelines will serve both the objective of the health systems as well as well as act as a protective and empowerment document to the CHWs who in my opinion have been abused by the system as well as we the health providers. The lack of any document to protect their interests especially those in rural areas where supervision and monitoring of responsible cadres are still inadequate and have placed CHWs literally at the mercy of their immediate supervisors. The work they are doing in contributing to achieving global public health deserves recognition. Such a document may help also to bring in younger people who can support the sector and again be empowered through skills training and can be helpful in scaling up such as youth friendly health services too. This will also address the inequalities in access and utilization of health care for the underserved as our country continues to struggle in reaching many against an inadequate workforce.

Thank you for such a document to all involved in this and to the global health leader (WHO) for ensuring its successful recognition.

But like any other Evidence based program, implementation in Zambia will require a well thought out multi- sectoral approach just like most developing countries where resources are limited to ensure sustainability. I feel with a great community involvement including business sector and a "Value for evidence" led system the guidelines will address the current human resource gap we are experiencing. The busineses running within these communities can be a great source of support for this program and must be involved from program designing stage.

For the most times that we have ignored the beneficiaries as part of the process of implementation, we have failed to sustain most programs and therefore I strongly feel community involvement through health information on all programs must be key to create a sense of ownership. Giving the community the power to have a say in this whole process will be crucial. Research continues to reveal that community involvement yields great results and Zambia must go this way.

My only question on this now for Hifa-Zambia is where are we in adopting the guidelines?

Best wishes to you all,

Flata Mwale - Medical laboratory Officer/ Student (MSc Global Health Implementation- College of Medicine Malawi)

HIFA-Zambia profile: Flata Mwale is a Student at the College of Medicine, University of Malawi. Professional interests: Health systems strengthening and health policy. Advocacy for equity and equality in access, utilization and distribution of health care. Email address: fltmwale AT