Call for the strengthening of community health systems

African governments have been urged to invest in community health systems and by extension community health workers for their citizens to maintain healthy lives.

Dr Herilinda Temba, an epidemiologist with the African Union said investing in community healthcare workers and systems will not only improve quality of care but also health expenditures in the long term.

Dr Temba contended that health and community systems are ‘dynamic, intertwined and overlapping systems’ that independently contribute to improved general well being at the local level.

She said community health workers play a critical role in primary healthcare provisions by bridging the existing health workforce gaps.

She spoke to the press at Hotel English Point Marina and Spa, Mombasa on the sidelines of a five-day community health regional capacity building workshop sponsored by the AU under the auspices of African Centers for Disease Control and Prevention (Africa CDCp).

Participants at the five-day forum are drawn from African countries in the Eastern, Northern and Southern regions of the continent. The medic said the current health systems in most African countries are reactive rather than being proactive.

She said African governments need to explore ways of implementing reforms to strengthen community health workforce programs to improve outcomes and access to basic health services across the board.

“It’s high time African governments focused and prioritized on preventing diseases before they strike and manifest by investing heavily on local healthcare systems and workers,” she said.

“The current health system in Africa is reactive rather than proactive and that the imbalance has hit communities hard,” she noted and called on African countries to define common approaches to strengthen health care at the community level.

Temba said community health workers have traditionally been overlooked despite playing a critical role in leadership and coordination at the community level.

“Community health workers contribute to increased access to the formal healthcare system or improved patient adherence to treatment regimens like antiretroviral therapy and tuberculosis treatment regimens among numerous other roles,” she said.

She said recent continental health surveys show that most countries don’t have community health strategic plans and that the few countries that have lack costed implementation plans.

She also called on African countries to tap into digital health to support community health workers.

“For example countries can harness the power of mobile technology to connect community health workers to their clients, peers, and supervisors, to new data and information, and to health systems,” said Temba.

She said, ‘It’s disheartening to see that many African countries are still using paper based data in the management of community health approaches in the face of technological advancement.”

She said many governments run community health systems often struggle with poor quality data from their community health worker programs, as well as ensuring the accountability of field-based staff and managing the quality of care that is being delivered at the last mile.

Dr Salim Hussein, Head Community Health Services at the Ministry of Health said increased community involvement in health matters is critical to the achievement of health related targets in the country.

Hussein said there is growing recognition that effective partnerships between communities and health systems are needed to achieve and sustain positive health outcomes.

He said the Kenyan government is committed to investing in community health workers to achieve the universal health coverage goals. He said they are alive to the fact that empowering community healthcare workers and volunteers will in the long run ensure the overall welfare of the communities.

Hussein said community health workers have the responsibility of mobilizing communities for involvement in health-promotion and disease-prevention activities at the grassroots level.

“The ministry of health will back the grassroots health workers with technical and financial support to ensure sustainability,” said Hussein.

He said Kenya seeks to rely on a robust community health workforce to fill critical gaps while delivering quality, affordable services closer to undeserved patients.