The Unsung Heroes of Health Care

We stand at a vital precipice in health. Despite great achievements in improving health outcomes globally and averting millions of deaths from preventable diseases—thanks largely to fulfilled commitments under the United Nations’ Millennium Development Goals, and now furthered by the Sustainable Development Goals—gaps in access to health services remain as pervasive as ever.

Over half of the world’s 7.8 billion people continue to lack access to health care. This is not simply a number—it is 13 million children who lack a single dose of any vaccine; it is 9 million newborns, children and mothers who die each year from preventable or treatable conditions. It is unacceptable and we must do more.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), said it best: “Our vision is not health for some. It’s not health for most. It’s health for all: rich and poor, able and disabled, old and young, urban and rural, citizen and refugee. Everyone, everywhere.”

To deliver on this promise of health for all we must increase investments in health systems and workforces—key among these are community health workers (CHWs).

Community health workers are trained health aides that work in the communities they serve. CHWs can be any gender or ethnicity, literate or illiterate—however one of the greatest assets they possess is the cultural norms and customs that establish a sense of trust in their communities.

CHWs are vital to closing gaps in health services in areas where there are health-worker shortages, specifically in rural areas where, globally, 1 billion people lack access to life-saving services. We need 18 million more health workers by 2030 if we are to achieve universal health care for all. We must act now.   

We know the incredible impact CHWs can have on improving health. In 2015, when West Africa was experiencing the worst Ebola outbreak in history, CHWs were key to stopping the spread of the virus by teaming with nurses and going door-to-door to bring people into care. As a result, the Liberian government created a national program to put a CHW in every rural community. Those workers have now identified over 4,000 potential epidemic events, improved vaccination coverage and increased the rate of children receiving medical care by over 50%, and one in every three children with malaria is now diagnosed and treated at home—avoiding expensive hospitalization.

If that weren’t impressive enough, for every $1 a country invests in community health workers, $10 is returned to society.

It is clear that investing in CHWs will help us achieve our global health goals and to provide universal health care for all. We must replicate and scale CHW programs across the globe. I applaud organizations like Last Mile Health and AMP Health—who are developing CHWs and strengthening health systems to bridge the gap between clinics and remote communities, bringing essential primary care services to the doorsteps of some of the most vulnerable people.

However, to realize a world where everyone has access to health care, we must reconcile a terrible injustice. A recent WHO report found that the poorest women in the world subsidize health care with their unpaid work totaling approximately $1 trillion–a figure that is larger than the economies of over 150 countries.

We would never expect a doctor or EMT to work for free and we should not expect that of community health workers. They have vital skills that should be compensated fairly.

Community health workers save lives. It’s that simple. We must do the smart thing—the right thing!—and invest in CHWs for the health of everyone, everywhere.