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
  • 2 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. These people 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 in two countries. What training do they receive? What challenges do they face – from outside and inside the communities? And what models prove sustainable? The project looks at Nepal. There, a force of 50,000 female community health workers is the backbone of the country’s health system. Villagers trust them and respect them highly. These female health workers do not receive a salary, but some make an income by selling hygiene products, pills or bandages which they receive at a low cost. It has been a proven sustainable solution.

The organisation Brac serves as a successful model for an organization that has been taken to scale successfully, as well as for south-to-south cooperation. How can this program be further improved? Currently, there is a pilot program in which health workers are being paid and also receive supervision support. Will the outcome of this program be used to reform the FCHV program in Nepal? What is the best approach to CHW?

The project shows Frontline Health Workers’ important and successful work in Global Health, reports on the challenges they face, and highlights long-term solutions. Especially with regards to the current Covid-19 pandemic, it becomes increasingly clear how much public cooperation is needed in order to effectively tackle a public health threat. Hence, Covid-19 prevention (and other diseases neglected due to the fight against Covid-19) will be a new story focus.

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