Scaling up Community Health Workers

أ) أهداف التعهد

The objective of this open pledge is to support the scale up of Community Health Workers globally. Community Health Workers deliver primary health care, improve health outcomes, and save lives. Community Health Workers bridge a critical gap between communities and healthcare systems, ensuring that everyone, everywhere has access to essential health services. By scaling up Community Health Workers, we can increase access to equitable, high-quality essential health services through community based primary health care and move closer to achieving Universal Health Coverage. Expanding Community Health Workers globally strengthens Red Cross and Red Crescents ability to address the theme of the 34^th International Conference, Navigating Uncertainty – Strengthening Humanity.

In many communities, access to essential health services remains a significant challenge. Community-based primary health care delivered by Community Health Workers provides a sustainable pathway for countries pursuing Universal Health Coverage and the attainment of the Sustainable Development Goals. Extending preventive, promotive, and curative health services at community level is a critical aspect of ensuring equitable access to high-quality primary health care. The gap in access to essential health services is exacerbated by a shortage of healthcare professionals and resources, leaving many individuals and families without the care they need. Community Health Workers are vital in addressing these disparities. They serve as the first point of contact for health services, providing crucial support and bridging the gap between communities and healthcare services.

Community Health Workers are trusted members of the communities they serve, present before during and after a shock, offering not only medical assistance but also emotional and social support. Well-trained, supervised, and resourced, Community Health Workers can effectively deliver primary health care, promote health education, and connect individuals to specialized services when necessary. Empowerment and training of Community Health Workers is essential, as it enables them to support others while also enhancing their own skills and resilience.

Community Health Workers are essential to global health security and play a critical role in pandemic preparedness and emergency response while helping to allay the health and economic shocks that follow. Effective primary health care requires a robust workforce at the community level, as highlighted by the Africa Union member states 2017 commitment to build sustainable primary health care and empower individuals and communities, the 2023 Monrovia Call to Action and the WHO Global Strategy for Human Resources for Health. Community Health Workers are crucial for achieving Universal Health Coverage and addressing global health security risks. Community Health Workers play a fundamental role in advancing the 2030 Sustainable Development Agenda by ensuring that essential health services are accessible to all. When recruited from their communities, well-trained, supervised, and resourced, Community Health Workers are trusted and integral to the health systems they support.

Through implementation of this pledge, States, the International Red Cross and Red Crescent Movement and other actors can expand efforts to scaling up of Community Health Workers. This will enhance the provision of primary health care and psychosocial support in emergencies, empowering Community Health Workers to better connect those in need with existing services. It will also enable Community Health Workers to support individuals affected by armed conflicts, natural disasters, and other emergencies with dignity and essential emotional support.

ب) خطة العمل:

The signatories commit to increasing the capacity of community health workers through one or more of the following five actions:

1. Promote the importance of Community Health Workers:Emphasize their role in providing essential health services and the need for their protection and wellbeing in relevant policy forums. This includes supporting country-led efforts to equitably integrate Community Health Workers into human resource and health sector plans, ensuring they are trained, supervised, supplied, protected from abuse, violence, or exploitation, and offered opportunities for career progression.
2. Invest in country-led community health strategies: Advocate for and provide funding support to costed and prioritized national and sub-national community health strategies such as the joint Africa CDC, IFRC Resilient and Empowered Africa Community Health (REACH) programme which aims to support the scale-up of 2 million Community Health Workers on the African continent. With recognition of the contributions Community Health Workers make to disease-specific outcomes, affirm an integrated approach to service delivery and strengthen the health system to ensure they are adequately stocked with the required medicines and
3. Enhance training and support:Ensure that all Community Health Workers, receive training relevant to their roles, sectors, and situations. Work with communities to ensure they support Community Health Workers which will enhance the delivery of primary health care at community level. Integrate the role of Community Health Workers into broader health and emergency response trainings.
4. Strengthen technical assistance and systems:Increase coordinated technical assistance that strengthens the capacity of Community Health Workers at the community level. This involves promoting cross-sectoral approaches to optimize health system support and service delivery, ensuring timely and flexible resourcing to the front line. Strengthen existing or build new systems for developing Community Health Worker skills and capacities, providing ongoing mentoring and supervision, including at the local level.
5. Build accountability and evidence:Establish mutual accountability between partners and governments by tracking progress toward institutionalizing community health. Build evidence on the impact of Community Health Workers and foster cross-country dialogue and learning to share best practices and innovations.
6. Provide high-level advocacy support:Elevate the Primary Health Care and community health agenda at country, regional and globally, level to promote the importance of Community Health Workers and their role in contributing to Universal Health Coverage and the Sustainable Development Goals.

ج) مؤشرات قياس التقدم المحرز

• National, regional, and international events where attention has been brought to Community Health Workers in humanitarian response, emphasizing their role and the importance of their protection and wellbeing.
• Number of Community Health Workers trained by the signatories disaggregated by age, sex, qualifications, trainings, social and economic diversity.
• Strengthened policy and legal frameworks to create an enabling environment.
• Sustainable and increased financing (domestic and external)
• Learning tools, platforms, and systems made available by signatories to enhance Community Health Worker capacities.
• Improved capacity and resilience of community based primary health care.
• Strengthened community health workforce (skilled, renumerated, supplied, protected)
• Allocation of additional resources by the signatories to enhance the Red Cross and Red Crescent Movement components and States’ capacity to support Community Health Workers.
• Improved availability and use of quality data and evidence to inform actions and learn.

د) الآثار المترتبة على الموارد:

The signatories will determine the resources required to implement this pledge based on the objectives and actions they take in their specific context.