Posted by: blog4globalhealth | 01/11/2012


The launch of a new coalition defines the critical role of health workers

As a mother, I know how troubling it is to care for a sick child. As a public health professional working with teams in developing countries for more than 20 years, I have a sense of just how many parents around the world share that worry on any given day. What is one thing that helps allay the worst fears of any parent? Having a health worker close at hand to help diagnose the problem and prescribe the solution.

That’s why, today, 16 non-governmental organizations are joining together to extend that lifeline to more families around the world. We are launching the Frontline Health Workers Coalition to recognize the critical role of those health workers who are the first and often only point of contact for millions of children and families who live beyond the reach of hospitals and clinics. Many of these frontline health workers are community health workers and midwives, although they include doctors and nurses as well.

The United States has been a leader in providing training and support to health workers to help them deliver better care and newly-developed cures to address some of the world’s major public health challenges, including AIDS, pneumonia, diarrhea, malaria and deaths to mothers and newborns during and around the time of child birth. We can’t quite estimate how many health workers have been trained from scratch, or had their skills upgraded thanks to U.S.-government-funded programs, but the numbers undoubtedly run in the hundreds of thousands and perhaps millions. The impact of these workers is well-documented in reduced maternal and child mortality rates (34 and 37 percent decreases respectively from 1990 to 2010) and increased numbers of people on antiretrovirals to treat HIV infection, use of bed-nets to reduce malaria cases and coverage of basic vaccines that save lives.

The Frontline Health Workers Coalition is calling for more health workers and better support for existing health workers who lack the training, supplies and supervision to further drive down death rates. As of today, the Global Health Initiative – the guiding strategy for U.S. government programs addressing health in priority developing countries – has no comprehensive health workforce development strategy. In addition, there is no overall target for health workers to be trained under the Global Health Initiative, which we believe could build additional accountability into these programs and encourage U.S. government partners implementing these training programs to collaborate better to address gaps in health workers in Global Health Initiative priority countries. The coalition is calling for the U.S. government to commit to training 250,000 new frontline health workers, as its part of a global effort to meet a shortfall the World Health Organization puts at over a million.

Last month, I took two American health workers – a midwife from Chicago and a nurse from Charleston, SC – to see community health workers in action in rural Guatemala. Of course, the American health workers wanted to jump in and help at an immunization outreach session, and to evaluate the newborns that we visited in homes high on hillsides. But we allowed these local community health worker heroes, most of whom had just an elementary school education, to lead the way because they were known and trusted by the families in the area. They grew up alongside their clients and had the best understanding of the local customs, culture and needs. And as we walked up treacherous paths following health workers on postnatal visits, I realized that there are some places in the world where you can still get a house call.

Mary Beth Powers is chief of Save the Children’s Newborn and Child Survival Campaign.

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