Big Milestones for Me and All Community Health Workers in Kenya

I was thrilled to receive Dr. Atul Gawande, Assistant Administrator for Global Health at USAID, last week at Mathare North Health Center–my link facility. 

I told him about how I, and my fellow community health workers (CHWs) in Kenya, support the Introducing New Tools Project to strengthen tuberculosis (TB) care. I go house to house to educate community members about TB. I screen for TB, and when I identify a person who may have TB, I bring the patient to this facility for further testing and treatment, which can now be done using new technologies.

CHWs have made significant strides in ensuring early detection of TB. I’m a link between my community and the facility, and I connect them to essential health services–not just for TB, but HIV, family planning, maternal health, vaccination services, and more. 

CHWs have made significant strides in early detection of TB.

I have gone to extraordinary lengths to become this visible, representing the impact of thousands of CHWs to the largest donor to global health.

My journey began with my own challenges accessing quality and appropriate primary health care services. I became a community health volunteer, or “CHV,” and gained knowledge and understanding of what my community’s health needs are. I continued to work as an unpaid CHV for years and realized I needed to advocate for fair pay for myself and other CHVs. I completed advocacy training and decided to co-create, with my colleague Margaret Odera, the CHW - Champions Network–a national movement for CHWs to advocate as a block for the interests and needs of all CHWs in Kenya, encourage greater leadership opportunities for us, and rally our community behind actions to improve all of our health and wellbeing.

CHWs demonstrate a deep passion for mentoring and guiding residents and fellows in achieving health for all. CHWs willingness to share their knowledge and expertise has undoubtedly shaped the next generation of health care professionals, fostering a culture of innovation and excellence. 

Dr. Gawande listens to other health workers at Mathare North Health Center. Photo courtesy Sheringham Elisha. 

Dr. Gawande’s visit was a remarkable recognition and testament to all frontline health workers’ exceptional contributions and groundbreaking work in the community. During his visit, different kinds of health workers at the health center discussed the gaps in TB and HIV response. We focused on promoting innovation and access to quality, safe, and affordable health care services for community members.

Dr. Gawande’s visit was a remarkable recognition.

Dr. Gawande said his visit to Kenya and specifically Mathare North Health Center was influenced by the positive outcomes for the fight against TB and HIV/AIDs. “Your accomplishments are a source of inspiration and motivation to the entire community health effort,” he said. “Your work should be replicated in other parts of the country and even in the world at large. I do not doubt that your future endeavors will continue to contribute immensely to the field of community health, improving the lives of countless individuals."

The same week Kenya’s President Ruto committed to hiring 103,000 CHWs, and said community health volunteers will now be known as community health promoters, will be equipped with modern equipment and deployed in communities across Kenya, and that USAID will help train them. I’m impressed by this bold step, and I am looking for our stipends to be changed to fair salaries. 

I’ll continue to advocate for funders to invest in me and other CHWs. 

Sheringham Elisha is a long-time advocacy partner of the Frontline Health Workers Coalition and has participated in several of the coalition's campaigns, including the recent "Invest in Me" campaign.

While the global community has pledged to end AIDS and TB by 2030, there is still urgent work to be done, including by CHWs and for supporting CHWs. With new approaches and technologies for detecting and treating TB we can make faster progress to end this disease, and new TB vaccines on the horizon could be a major boost to TB prevention. But to reach everyone in need, policy-makers must invest in the health workforce and follow through on funding commitments. That’s why I’ll continue to advocate for USAID and other funders, including national governments, to invest in me and other CHWs. 

I am also asking the drafters of the UN Declaration on TB now being negotiated to not forget me and the role we CHWs play in the fight to end TB and to be sure to include strong commitments for our professionalization and remuneration.