hello world!
Published: May 28, 2024

CHW advocates: amplifying voices for change

For a long time, discussions about community health workers (CHWs) have been happening without them in the room, resulting in policies and programs that often fail to support and value their work. As a result, CHWs around the world have been unpaid, undertrained, and under-resourced–only 14% of CHWs in Africa are salaried. This perpetuates gender inequality, as the majority of CHWs are women. “It’s time for my voice to be heard,” says Grey Odero, a Lwala-supported CHW in Migori County. 

As the first point of contact in the health system, CHWs have unique, first-hand knowledge about the challenges their communities face when accessing health care. They are also the most powerful voices in demanding payment, training, supervision, digital tools, and commodities–all the requirements for building professional cadres of CHWs. Lwala trains CHWs as advocates, supports CHWs as they organize into networks that can shift policy, and amplifies the movement for CHW professionalization that extends far beyond Kenya’s borders. We provide CHWs with the resources and platforms to effectively advocate for themselves and their communities.  

CHW advocacy training

“CHW voices must be amplified to address issues that prevent them from providing high-quality care,” says Caroline Wanyonyi, CHW Engagement Manager at Community Impact Health Coalition (CHIC), a coalition promoting proCHW principles. CHWs improve access to care by providing services at the community level and linking communities to the formal health system. They also offer valuable insights that help policymakers and health providers create tailored solutions for their communities. “CHWs’ involvement in advocacy goes beyond safeguarding their interests,” Caroline says. “It's about driving real change by addressing the root causes of disparities in health care.” Ultimately, this improves health outcomes and rebuilds trust in the health system.

In 2021, Lwala partnered with CHIC and CHWs around the world to develop an advocacy training course for CHWs. This training prepares CHWs to advocate for change at the global and national levels, as well as within their communities.  

“We CHW advocates represent the voices of our peers and the community. The advocacy training has enhanced my confidence to champion sustainable solutions for my community in decision-making forums.”
- Grey Odero, Lwala-supported CHW

Around the world, more than 3,600 CHWs have completed the course. Lwala is working with partners to expand this training within Kenya–so far, 750 Lwala-supported CHWs in Migori County and a total of 2,400 nationally have completed the training, and now CHW advocate champions are training their peers. Within the year Lwala plans to expand the advocacy training to two more additional counties (Baringo and Homabay) with plans to train 400 CHWs. 

CHWs are putting these new skills to use on the global stage. In March of this year, for example, a Lwala-supported CHW advocate, Maureen Wauda, spoke on a panel at the Skoll World Forum that focused on equipping CHWs around the world with digital tools. Maureen also shared her story in a new video documentary, developed with BBC Storyworks, the WHO Foundation, and Medic–and she’ll be advocating on behalf of CHWs at the World Health Assembly in Geneva this May.  

Building a movement of CHWs across Kenya

As CHWs are trained in advocacy, they are building a CHW-led movement towards professionalization. CHWs are organizing through a newly established national CHW Network that monitors government policies and commitments to CHWs–and ensures they are fulfilled. “Our nationwide advocacy is securing an environment for CHWs to thrive professionally and to make a meaningful difference in their communities,” says Sherringham Elisha, Secretary-General for the National CHW Network. “We have seen that when we speak in a unified voice, decision-makers listen to and value our opinions.”

Late last year, national momentum for community health culminated with the launch of the electronic Community Health Information System, the distribution of commodities to 100,000 CHWs, and the passage of new Primary Health Care legislation that codifies CHW payment. The national CHW network played an active role in shaping the Primary Health Care Act by engaging in technical working forums, drafting, and presenting a memorandum.

 “We were excited when the President signed the Primary Health Care Bill into law. We actively voiced our opinions during its creation. Now, the new law supports CHWs' interests and advances healthcare for all.”
- Sherringham Elisha, Secretary-General for the National CHW Network

The national network collaborates with other advocacy movements to professionalize CHWs and drive policy change. This includes Community Health Units for Universal Health Coverage, a national platform advancing community health that was co-founded by Lwala, as well as CHIC globally. 

We are also working with CHIC to ensure that CHW advocates in Kenya are enrolled in a “speakers bureau”—a database of advocates who can amplify the voices of their peers and communities on a global scale. As a result, CHWs are gaining unprecedented–but long overdue–access to global opportunities to advocate for their recognition, professionalization, and career advancement. For example, last year, Millicent Miruka, a Lwala-supported CHW, delivered a keynote speech at the USAID-MOMENTUM event, highlighting the community's progress in safe and skilled childbirth and urging for renewed collaboration.

“We need to be recognized for the important work that we do in our communities. As a trained CHW advocate, I want to be at the table when the decisions about us and our communities are made. As the saying goes, nothing about us without us.”
- Millicent Miruka, Lwala-supported CHW from Rongo Subcounty

Building regional CHW networks for amplified advocacy

To amplify the voices of CHWs, Lwala aims to support the establishment of CHW networks at the county level. This is essential in Kenya’s devolved system in which county governments are responsible for health delivery and health budgets. In Migori County, for example, the CHW network we helped grow now has a robust membership of 1,500 and counting, and it has become a powerful force in influencing county policies and practices. To expand the network’s reach, CHWs are actively recruiting their peers through grassroots efforts, cultivating a sense of solidarity and empowerment among its members. In Baringo and Homa Bay Counties, we are working hand-in-hand with CHWs to develop networks, growing the proCHW movement and centering CHW voices in community health policy throughout Kenya.

By organizing into a network, CHWs have gained access to spaces where they can collectively advocate for improved services to benefit their communities. “When we speak in one voice, we can secure a seat at the table,” says Benard Otieno, who serves as the Chair of the Migori County CHW network. “We feel empowered and motivated to stand up for the issues that advance our well-being and that of our communities.”

Through the network’s advocacy, CHWs’ asks have been included in county work plans and budgets, as well in the Community Health Services Bill that was passed into law. Recently, representatives from Migori's CHW network also supported the development of the national Primary Health Care Act, which includes specific provisions on CHW professionalization and payment.

“We have seen that when CHWs unite and speak together, it leads to innovation, ownership, and accountability in their work. It also boosts motivation and job satisfaction. Our goal is to have all CHWs in Migori trained as advocates and registered as network members.”
- Christine Mugambi, Lwala’s Policy, Advocacy and Partnerships Manager

—--------------

CHWs deliver healthcare for underserved communities and their voices are crucial for the development of equitable health policies and practices. Empowering them to speak out isn't just about making policies and programs better suited to community needs; it's also about creating a space where fresh ideas can thrive, leading to better health outcomes. By listening to CHWs, we can better understand their challenges and find lasting solutions together.

Agency, health, and wholeness of life.

SUPPORT LWALA
linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram