The global health community is gathering in New York next week for the United Nations (UN) Multi-Stakeholder Hearing (8th-9th of May) on Universal Health Coverage, Tuberculosis (TB) and Pandemic Preparedness and Response. With seven years left until the UN’s global deadline of delivering universal health coverage (UHC), mothers2mothers (m2m) will be in New York—and we are looking forward to passionately advocating for the need for community-led solutions, and the importance of paid, professional, and fully digitalised female community health workers (CHWs) to be front and centre in policymakers’ thinking and approaches to delivering health for all.

An opportunity to take stock: the UN Multi-Stakeholder Hearing on Universal Health Coverage

m2m community health worker in a clinic in South Africa.

Bringing together representatives of Member States and UN agencies, civil society, policymakers, non-governmental organisations, academia, and the private sector, the two-day discussions will be an opportunity to take stock of the progress made in creating a world where everyone, everywhere can access the health care they need, whenever and wherever they need it. Critically for m2m, it will also be an important platform to ensure that CHWs are a key part of the roadmap and solutions that will be laid out at the UN High Level Meeting on UHC in September. 

The good news is that m2m and our partners have made important progress in advancing the case for CHWs to be fairly paid, formally recognised, and supported, especially in the last few months as important and real results have been delivered in the lead up to September.  

The Action Agenda

One of these is the Action Agenda from the UHC 2030 movement, which m2m fed into both directly, and together with our partners at the Community Health Impact Coalition (CHIC). The Action Agenda is a blueprint of action-oriented policy recommendations by public health stakeholders for country leaders to implement to build resilient and equitable health systems, advance UHC and health security, and deliver health for all by 2030. 

The Action Agenda is made up of eight Action Areas. The recommendations in each Area will directly feed into the negotiations of the 2023 UHC political declaration that will be presented at the UN High Level Meeting in September, which will form the roadmap for how to achieve health for all by 2030:    

• Action Area 1: Champion political leadership for UHC  
• Action Area 2: Leave no one behind   
• Action Area 3: Adopt enabling laws and regulations  
• Action Area 4: Strengthen the health and care workforce to deliver quality health care  
• Action Area 5: Invest more, invest better   
• Action Area 6: Move together towards universal health coverage   
• Action Area 7: Guarantee gender equality in health  
• Action Area 8: Connect universal health coverage and health security   

m2m was delighted to see included more explicit and robust recommendations around CHWs and community-led responses included in the Action Agenda, following input from ourselves and other CHIC members. In particular, we are glad that the Action Agenda includes: 

• Integrated services and approaches to support UHC and health security, as well as health emergencies preparedness, explicitly highlighted in the implementation of policies, laws, and regulations (Action area 3 and 8).  
• The need to increase financing, recruitment, development, compensation, training, and retention of health workers highlighted in the recommendations to strengthen the health and care workforce to deliver quality health care (Action area 4). 
• The associated urgent recommendation for increased financing for primary health care, for which CHWs are critical players, to strengthen health systems and scale up services (Action area 5). 
• Gender equality (including closing the gender pay gap) in health systems and decision-making underpinned as an area of emphasis and focus, with a clear mention of CHWs (Action area 7). 

The fact that the Action Agenda’s amendments and updates reflected our recommendations, as well as those of the wider global health community shows that leaders are listening, and that civil society does have power and influence. This should give us all inspiration to push on and continue to advocate for grassroots voices to be recognised and part of the conversation.

The missing piece: digital health

m2m community health worker using a digital health app.

While m2m is pleased to see CHWs highlighted and recognised in such ways, one important element however continues to be overlooked: the urgent need for CHWs to be better trained and equipped with digital health technologies. Why is this a critical omission? Because we have seen how CHWs have been able to close the last mile in reaching marginalised and vulnerable populations by complementing their life-saving in-person services, with remote and technological support. Digital tools also help CHWs deliver and measure their services, as well as tailor them depending on their clients’ risk profile and health needs, and provide their clients with real time data and guidance. As such, digital health represents an important string to the bow of CHWs as they continue to play a major role in health service delivery. 

Take action

As we look to our engagement at the Multi-Stakeholder Hearing next week, these are the issues that will be at the forefront of our minds and of our conversations with partners, old and new.  If you want to support us during this critical week, follow us on social media and help amplify our ask for greater investment, better recognition, and improved working conditions for CHWs everywhere. We are committed to the areas in the Action Agenda, and urge UN Member States to embrace it as the foundation for the negotiating document for the Political Declaration on UHC.