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Tackling health inequalities to leave no one behind

mothers2mothers (m2m) was delighted to join long-time supporter Johnson & Johnson (J&J) at the European Development Days 2019—a two-day conference in Brussels, Belgium, that addressed global inequalities with the goal of creating a world that leaves nobody behind. With much of our work aimed at tackling inequalities in accessing healthcare in sub-Saharan Africa, m2m highlighted the significant strides we have made at the community level in bridging those gaps by employing women living with HIV as community health workers (CHWs).

The panellists at the European Development Days 2019

m2m’s Global Development & Strategic Engagement Director Emma France joined representatives from J&J, the European Commission, Amref Health Africa, Living Goods, and the Financing Alliance for Health for a cross-sector conversation on the role of CHWs in achieving health for all by 2030. Kicking off the session, Ben Davies, J&J’s Global Community Impact Lead for Europe, the Middle East, and Africa (EMEA), highlighted a report from the World Health Organization (WHO) which found that an estimated one third of the necessary health sector investments will need to be invested in the health workforce to achieve better health by 2030: “There is no health without people delivering it.”

According to the WHO, at least half of the world’s population still does not have full access to essential health services. In sub-Saharan Africa, one of the contributing factors is a shortage of 4.2M health workers, which is expected to rise to 6.1M by 2030, leaving many women and families struggling to access vital lifesaving medical care. As the bridge between the community and primary health systems, CHWs, such as m2m Mentor Mothers are playing a vital role in changing the tide.

Ben Davies from Johnson&Johnson introducing the panel discussion

The panellists shared why CHWs are effective in improving access to preventive care. Henriette Geiger, the Director of the People and Peace Directorate at the European Commission, explained: “We know how efficient it is to have basic health messages delivered to the community by someone from the community, especially when it comes to reaching young girls and women.” And all the panellists were clear that health workers represent an essential link between health facilities and communities—they advance UHC by taking health services to hard-to-reach individuals and communities, at a convenient time and place, and also by following up and supporting those who have been seen at a health facility to stay on treatment. 

Emma France talked about how CHWs have also become a crucial resource and support system for doctors and nurses working in understaffed health centres: “At m2m, we’ve had male nurses and doctors who were circumspect about the integration of Mentor Mothers at first, worried they would step on their toes. Now, they’ve become some of their strongest advocates, stressing what an integral part of the health team they’ve become.”

Emma France and the panellists discussing the added value of community health workers

The conversation quickly turned to the remuneration of health workers, many of which still operate as unpaid volunteers. The Financing Alliance for Health’s Angela Gichaga’s message was clear: “health workers are not only a health agenda, they are a development agenda… an investment rather than a cost.”

At m2m, we are proud of the fact that we train, employ, and pay Mentor Mothers. Their employment contributes to financial security for themselves and their families. By virtue of being professionalised, Mentor Mothers become role models, putting a face to empowered, strong, and healthy HIV-positive women, and thereby helping to reduce HIV-related discrimination and gender inequality.

While the potential of CHWs was widely recognised by panellists and members of the audience, Dr. Elizabeth Wala from Amref Health Kenya reminded everyone that they are not the “magic bullet” to achieving UHC: “They complement a system with many moving parts. They often are the forgotten part of health services delivery, but they principally act as a link between communities and the formal health system.”

Left to right: Thomas Opiyo Onyango, Living Goods, Henriette Geiger, European Commission, m2m’s Emma France, Angela Gichaga, Financing Alliance for Health, Dr. Elizabeth Wala, AMREF Health Africa and Ben Davies, Johnson&Johnson

Thomas Opiyo Onyango from Living Goods echoed this, declaring: “We absolutely need all hands-on deck. This is a collective responsibility we have, and everyone must get involved—especially the private sector who should use its expertise to help us achieve the long-term goal of UHC.” Thomas also added that all stakeholders should leverage the potential of technology to ensure an impactful, efficient and timely delivery of health services. From their experience, technology – such as performance management and data collection – supports strong decision making.

So how do we build partnerships that work and last? In Andrea Gichaga’s powerful final words: “Engage early. Engage meaningfully. Engage widely. And engage long-term.” At m2m, we couldn’t agree more!

You can listen to the full panel discussion, by tuning into the podcast here.

We are grateful to J&J and the European Development Days for inviting us to participate in this important conversation. Sign up to our newsletter or follow us on TwitterFacebook, and Instagram to hear from the women on the frontline who are making this change happen.

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