On the Frontline – the Daily Struggle of Female Community Health Workers


The power to improve global health is in the hands of community health workers, but the WHO warns of an immediate shortfall — what are these women’s daily challenges and what are sustainable solutions?

  • €15,505 Budget in Euros
  • 2020 Final release date
  • 6 Round winner
  • 3 Locations

They are on the frontline in the fight against preventable diseases. They themselves live a harsh life. They go to places no one else wants to go: Community Health Workers. Without them, health programs worldwide could not be implemented. In May 2019, the World Health Assembly concluded: “Community health workers have a key role to play in delivering primary health care – they speak local languages and have the trust of local people.”

Yet, the WHO warns that in ten years there will be a shortfall of 18 million health workers. Already today more than 400 million people lack access to basic health services. Many die of diseases that could have been prevented. Hence, a major task today is bringing medicine and simple health care advice to every corner of countries that sometimes lack basic infrastructure.

Community Health Workers do just that. They go from doorstep to doorstep. New technologies allow these non-medical professionals simple testing methods: Smartphone apps help with diagnoses, and they can be used to monitor the health status of a community. The tools keep improving. But innovations cannot reach areas where they are most needed without Community Health Workers walking the last mile. In other words: The power to improve Global Health is in their hands. “Yet the world continues to underestimate their capabilities and contributions”, argues health professional Maha Barakat. Only recently have states come to understand that.

This project sheds light on these key players in Global Health, by reporting on the daily lives of frontline health workers in remote communities. What training do they receive? What challenges do they face – from outside and inside the communities? And what models prove sustainable? We look at three countries.

In Nepal, 50,000 female community health workers are the backbone of the country's health system. They are trusted and respected by villagers. Some make an income by selling hygiene products, pills or bandages which they buy at a low cost. But they do not receive a regular salary. A pilot project and some health workers aim to change that.

Liberia in West Africa was hit hard by the Ebola crisis. But the country's government learned its lessons and started to build a countrywide community health workforce. Can it serve as a role model for other African countries?

Zambia has established a Community Health workforce too. Professionally trained Community Health Assistants help fight diarrhoea, pneumonia, malnutrition or the killer disease Malaria. What impact did they have so far, and what challenges lie ahead?

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