Empower village health workers

Lazarus Sauti

People who live in poor, remote places in Zimbabwe face considerable challenges receiving health care.

The high cost of treatment and transportation, the time required to travel to the nearest health facilities, and the stigmatisation associated with disease make it difficult, if not impossible, for them to access necessary services.

The fact that qualified health professionals shun these poor, remote areas further complicates the situation and puts rural dwellers in a fix.

Most communities, however, are relying on village health workers – members of a society who are chosen by area members or organisations to provide basic health and medical care to their community.

Most, if not all, of the village health workers in Zimbabwe have been especially selected by the elders in their villages because of the respect they have earned in the community.

Silas Muchetu, a village health worker in Buhera in the Manicaland Province, says providing community support systems is the perfect avenue to reach the millions of people in need of health services.

“As village health cadres, our interventions are an effective platform for extending health care delivery as well as improving health outcomes in our communities.

“We are playing a crucial role in our communities by reducing infant and child mortality and morbidity, improving health-care-seeking behaviours and providing low-cost interventions for common maternal health problems,” he said.

Village health workers are also effective since they overcome language and cultural barriers that limit access to health care in most rural communities in developing countries, a fact supported by the United Nations health agency, the World Health Organisation.

The WHO adds: “Village health workers close the gap of doctors and nurses in hard to reach communities in developing countries simply by visiting patients at home, assess their health, and link them with health centres as well as hospitals.

“Living in the communities where they work, village health workers are trusted and welcomed into patients’ homes to provide high-quality, cost-effective services for a wide range of health problems.”

The United Nations Children Fund (UNICEF), a UN agency that provides long-term humanitarian and developmental assistance to children and mothers in developing countries, says village health cadres also make sure patients have food, housing, and safe water so that they quickly recover from diseases and remain well.

“Village health workers are part of the lifeblood of the health system in developing countries, empowering families to strengthen their own health through preventative measures,” said the UNICEF, adding that “they (village health workers) lead education campaigns on topics such as mental health, sexually transmitted diseases, and palliative care, and empower community members to take charge of their own health.”

Community Working Group on Health director, Itai Rusike, says village health workers are the umbilical cord between rural communities and local health services in Zimbabwe, like any other developing nation.

He added that with the increasing disease burden in the country there is need to have more village health workers as they are critical cadres in primary health care – ‘essential health care’ that is based on scientifically sound and socially acceptable methods and technology, which make health care universally accessible to individuals and families in a community.

“Community health workers play a pivotal role in the provision of primary health care at the community level for marginalised and some of the hard to reach places hence there is need to give them more space in the health sector,” he said.

To achieve better health for all, notes the WHO, there is need to empower village health workers. Training is crucial in empowering them as it enables these cadres to recognise signs of serious or complicated illnesses, which require sophisticated treatment in clinics or hospitals.

Unfortunately, says Rusike, the government through the Ministry of Health and Child Care is not recognising the role of village health workers who are bridging the gap of doctors and nurses in most communities in the country.

“Zimbabwe with its population only has about 9 000 village health workers meaning that the Ministry of Health and Child Care does not recognise their role yet they are critical cadres in bridging the gap of doctors as well as nurses in hard to reach communities,” he said, adding: “Rwanda has about 60 000 village health workers and this has really played a part in the improving of the health system in that country.”

True to Rusike’s words, village health workers, despite their enormous contribution, are still facing socio-economic challenges such as lack of training as well as financial resources, and this is hindering their work. Some are forced to work without protective clothing while others travel long distances to help desperate patients. .

The government, urges Rusike, therefore needs to increase its budget towards village health workers so as to sufficiently promote comprehensive access to primary health care at community level, specifically for the hard to reach populations.

“Village health workers are pivotal in programmes such as HIV and Aids, malaria control, home based care activities and maternal as well as child health hence the need for more resources,” he added.

To accelerate the attainment of universal health coverage in remote areas, international partners, United Nations agencies as well as national stakeholders in the health fraternity should also support the government in its effort to empower village health workers.