07/05/2024
"In the past two years(2022-2024), UNICEF and Africa CDC have achieved significant milestones in strengthening Africa CDC’s institutional capacity and catalysing community health programmes, immunisation systems, emergency response, and supply chain enhancement. Collaborative efforts secured the procurement of COVID-19 vaccine doses and essential cold chain equipment for routine immunisation for Member States.
On 29th February 2024, the leadership of the Africa CDC and UNICEF announced an extended partnership dedicated to four key outcomes namely;Supply chain management, Stronger, more equitable primary health care and emergency preparedness and response, Pooled procurement and Africa Manufacturing.
This collaboration builds on the 2022-2024 Partnership Framework Agreement between our two organizations, which aims to achieve the goals outlined in the African Union Agenda 2063: The Africa We Want. At the core of this initiative is high-level advocacy for political prioritization and integration of Community Health Workers (CHWs) into human resource and health sector plans with the plan to deploy 50,000 CHWs over the next two years, progressing towards 500,000 by 2027. To achieve this, the partnership builds on the Monrovia Call to Action by reinforcing commitments to invest in, scale, and strengthen community health programs and advance efforts to make professional CHWs the norm." H.E Dr. Jean Kaseya, Director-General Africa CDC.
This week, Africa CDC and UNICEF are hosting 20 countries(Ghana included), 4 delegates each from the five regional blocs of Africa Union Member States for a Consultation Workshop aimed at the deployment of 500,000 community health workers to strengthen PHC, Immunization and Emergency Preparedness and Response. The worksop started yesterday with over 130 participants attending.
I am humbled and privileged to be working on the side of the Africa CDC Community Health Specialist in coordinating and executing this high level workshop.
Background Information
Background
Africa is a continent with a rich and diverse cultural heritage, but it also faces many challenges when it comes to health and healthcare. The concept of community health on a continental level is crucial for addressing these challenges and improving the overall well-being of the population.
One of the key aspects of continental community health in Africa is the need for a collective approach to health promotion and disease prevention. Many countries in Africa have limited resources and infrastructure for healthcare, making it difficult to provide adequate care to all citizens. By focusing on community health initiatives that involve the whole continent, resources can be pooled and shared to ensure that everyone has access to essential healthcare services.
Responding to the evolving challenges in public health systems, the African Union (AU) made firm commitments at its 29th Ordinary Session in 2017 to strengthen the Community Health Workforce (CHW) by endorsing the 2 million CHWs initiative. This was in recognition of the role of CHWs as a vital Human Resource for Health (HRH) in Africa by AU Heads of State and Government. The significance of the role of CHWs was further emphasized by their invaluable contributions during the COVID-19 pandemic.
In 2022, the AU Heads of State and Government entrusted the Africa Centres for Disease Control and Prevention (Africa CDC) with leading a transformative New Public Health Order to ensure the health and economic security of Africa, aligning with the continent’s developmental blueprint: “Agenda 2063: The Africa We Want” and placing strengthening the public health workforce at its core. In October 2022, a high-level Community Healthcare Worker consultative meeting, attended by representatives from 42 AU Member States, advocated for a continental coordination mechanism and a national-level coordination platform to enhance the coordination, collaboration, and communication among stakeholders in community health.
In October 2022, the first High-Level Consultative Meeting on the Community Health Workforce, attended by representatives from 42 AU member states, recognized these challenges and called for the establishment of a continental coordination mechanism and a coordination platform at national level to improve coordination, collaboration, and communication between community health stakeholders. Other high-level meetings held at continental and global level have affirmed the need to strengthen this collaboration, notably.
In March 2023, the Monrovia Call to Action was endorsed in Liberia, calling for accelerated implementation of the community health worker initiative.
In May 2023, a call for the adoption of a unified plan, budget and monitoring and evaluation framework was made at the high-level ministerial event on community health workers during the World Health Assembly.
In September 2023, Africa CDC launched the Joint Country Support Plan to help AU member states implement a coordinated approach to planning community health systems interventions.
In October 2023, the Community Health Delivery Partnership Program (CHDP) was launched to accelerate community-level priorities in countries through primary health care.
In December 2023, a collective approach to financing community health in Africa was announced at the "Reaching the Last Mile" health forum, securing a commitment of $900 million for community health investments, 74% of which was earmarked for Africa.
To meet this need, Africa CDC has set up a continental coordination mechanism (CCM) for community health in Africa. This initiative, which has been endorsed by 42 AU member states, aims to bring together all community health actors around a common goal, namely the development of resilient, integrated, sustainable and effective community health personnel, programs and systems in Africa. More specifically, the CCM aims to ensure a coherent and inclusive participatory approach to effective goal setting, regular review and monitoring of progress, and effective resource mobilization, including increased and more equitable distribution of public funds allocated to community health.
The vision of Africa CDC as the Technical Wing of the AUC is to propel the global and continental agenda of advancing the course of Primary Health Care in Member States through the institutionalization, integration and sustainability of Community Health Worker Programme to accelerate the achievement of Universal Health Coverage by 2030 and beyond.
Africa CDC vision on Community Health is linked to the following continental frameworks:
1. Agenda 2063: The Africa We Want
2. Call to Action: Africa’s New Public Health Order
3. Africa Health Strategy 2016 - 2030
4. Manifesto of the Africa CDC Director General
5. Africa CDC Strategic Plan 2023 - 2027
6. Catalytic Framework to End AIDS, TB and Eliminate Malaria by 2030
7. 3rd International Symposium on Community Health Workers in March 2023, leading to the development of the Monrovia Call for Action.
The primary objective of theses efforts is to seamlessly integrate these initiatives into existing health systems, institutionalize their practices, and secure long-term financial sustainability.
It is worth mentioning that, the African Union Member States have made significant progress in strengthening community health systems across the continent. The findings of studies carried out in 2020 by the African Union Commission, Africa CDC and its partners show that, despite the progress made, certain challenges still need to be addressed, notably the inadequate funding and sustainability of national community health programs, for which only 21% of participating Member States have an investment case, gaps in the community health information system, for which 71% of countries still use a paper-based data collection system and 32% have no database of community health workers; gaps in community health policies and guidelines, for which only 55% of countries have a costed strategic plan and 18% have no plan at all, among other challenges coupled with lack of coordination of players characterized by CH programs verticalization.
Recognizing the growing interest among Member States in strengthening their community health systems for financial sustainability, with the formulation of clear roadmaps and implementation timelines, Africa CDC has responded by devising ways of advancing political will of Heads of States. This strategy is designed to address community health challenges at various levels, employing a holistic and sustainable approach.
By: Dr. Barnabas Kwame Yeboah
