Community Health Workers: Tackling the triple threat of Diarrhea, Malaria and ARI in Chokwe District Mozambique


CHWs Working for their community

Diarrhoeal disease, Malaria and Acute Respiratory Infections constitute the significant bane of Mozambique’s poor health indices. Integrated community case management (CCM) has proven to be particularly effective in reducing the burden of these ailments through the use of community health workers in delivering low cost oral rehydration therapy, antimalarial and antibiotics to treat acute cases of these diseases at the community level. Calls to implement a scale-up policy in order to provide coverage for the entire country remain to be heeded. Low access to health care remains a significant challenge to the population with about 30% of the population live in communities that are beyond a 5km walking distance to a near-by health facility (such as in the Chokwe District of the Ghaza Province).

Statistics reveal Mozambique has one of the worst health indices in the world. Inadequate human resources has also been identified as a major problem, with only 500 physicians available for an over 18 million population. In most community-based programs, the volunteers were overwhelmed by the ratio of those seeking care to each volunteer. However, in this case, the program was unique, in being able to train an extensive pool of 2,300 volunteers who delivered services, each to only ten households thereby promoting the concept of universal coverage for every child.

Like every policy/program, a number of challenges exist. The benefits however outweigh these. Providing incentives to motivate community workers and sustaining their services are major concerns.  Other challenges include the issue of medication amongst other supplies from central level to district and the management of these commodities by community workers. Key stakeholders such as UNICEF, USAID and the Health Ministry are firmly behind the full implementation of the policy (CCM scale-up).

In conclusion, community case management remains the best approach and for the portuguese speaking nation, this is indeed the need hour. Mozambique with its teeming population already faces severe shortage of health care providers and the best solution is “task-shifting” and involving the community health workers and the community in their own health care. This way the community will be active partners in health service delivery, which will in turn help the country to take action and ultimately improve her poor health indices.


5 Responses to “Community Health Workers: Tackling the triple threat of Diarrhea, Malaria and ARI in Chokwe District Mozambique”

  1. sbfphc Says:

    Volunteer CHWs are an important resource in primary health care. Some countries like Rwanda have institutionalized the process and every village has 4 – 2 for community case management, 1 for pregnant women and 1 for general mobilization. Burkina Faso has created a new directorate in the Ministry of Health to oversee community activities and volunteers. In contrast Angola, with serious health infrastructure gaps, refuses to allow community members to handle medicines/treat.

  2. primeteam4 Says:

    Interesting!! It’s good to learn that a low cost model that is replicable in rural settings, particularly in Sub-Saharan Africa is achieving successes. I hope other countries adopt similar models to help reduce some of the preventable infant deaths. However, I wonder if Angola’s reason for refusing to adopt this model isn’t due to the fact that keeping medicines away from CHW, guarantees strict control and reduces abuse of antibiotics and development of resistant strains?

  3. Community Health Workers: Tackling the triple threat of Diarrhea, Malaria and ARI in Chokwe District Mozambique | tnyenswa Says:

    […] Community Health Workers: Tackling the triple threat of Diarrhea, Malaria and ARI in Chokwe District… […]

  4. kaylee777 Says:

    I’m guessing community health workers in this case were volunteers from ‘Care Group’ model. Community health workers with different shapes and names have been key agents in community empowerment in many places that led to significant decrease in infant and child mortality/morbidity. Also, I think progress in ‘levels of involvement’ from community mobilization to community control can be made by people in community and outside agents working together and establishing community health worker concept with good quality and commitment.

  5. itseajuyah Says:

    The concept of incorporating of these working cader (CHW’s) within the framework of a national health ministry’s program such as in Bukina -Faso goes some lenghty way to making it really legitimate and accepted. This definately has to be looked into for a number of developing countries that have these cader of workers but are ot specific on thir job descriptions/site of work/operations.
    In Nigeria these workers prefer to stay at health posts/localheath clincs and are never really in the community.

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