Given the increased global interest in CHWs, I was surprised to read this in the January 2020 issue of the WHO Bulletin: 'The share of development assistance invested in the CHW projects was small, unstable and decreasing in recent years [2007-17].' It would be interesting to know what are the projections for 2018 and 2019. Also, has the reduction in development assistance been offset by an increase in domestic funding? (In the Discussion section, the authors note: 'low-income countries are not able to fully support a national CHW programme with domestic public spending alone'.
CITATION: Development assistance for community health workers in 114 low- and middle-income countries, 2007–2017
Chunling Lu, Daniel Palazuelos, Yiqun Luan, Sonia Ehrlich Sachs, Carole Diane Mitnick, Joseph Rhatigan & Henry B Perry
Objective: To estimate the level and trend of development assistance for community health worker-related projects in low- and middle-income countries between 2007 and 2017.
Methods: We extracted data from the Organisation for Economic Co-operation and Development’s creditor reporting system on aid funding for projects to support community health workers (CHWs) in 114 countries over 2007–2017. We produced estimates for projects specifically described by relevant keywords and for projects which could include components on CHWs. We analysed the pattern of development assistance by purpose, donors, recipient regions and countries, and trends over time.
Findings: Between 2007 and 2017, total development assistance targeting CHW projects was around United States dollars (US$) 5 298.02 million, accounting for 2.5% of the US$ 209 277.99 million total development assistance for health. The top three donors (Global Fund to Fight AIDS, Tuberculosis and Malaria, the government of Canada and the government of the United States of America) provided a total of US$ 4 350.08 million (82.1%) of development assistance for these projects. Sub-Saharan Africa received a total US$ 3 717.93 million, the largest per capita assistance over 11 years (US$ 0.39; total population: 9 426.25 million). Development assistance to projects that focused on infectious diseases and child and maternal health received most funds during the study period.
Conclusion: The share of development assistance invested in the CHW projects was small, unstable and decreasing in recent years. More research is needed on tracking government investments in CHW-related projects and assessing the impact of investments on programme effectiveness.
Best wishes, Neil
Coordinator, HIFA Project on Community Health Workers - Supported by the World Health Organization
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