‘Leaving no-one behind’: how community health workers can contribute to achieving the Sustainable Development Goals

In the drive to achieve the Sustainable Development Goals (SDGs) by 2030 there is renewed focus on the contribution of community health workers (CHWs). As key partners in health care delivery, CHWs play a critical role in promoting equitable expansion of coverage for a range of preventive, promotive and curative services related to reproductive, maternal, newborn and child health, infectious diseases and noncommunicable diseases.¹ In building on the achievements of the Millennium Development Goals, the comprehensive efforts required across all parts of the health system to ensure that no-one is left behind include maximising the potential of CHWs.

Reflecting the renewed focus on CHWs, the First International Symposium on Community Health Workers was held in Kampala, Uganda, 21–23 February 2017, with the theme ‘Contribution of Community Health Workers in attainment of the SDGs’. The Kampala Statement highlights the potential of CHWs to contribute to attaining a range of SDGs, including SDG 1 (ending poverty), SDG 2 (ending hunger and ensuring food security), SDG 3 (health and wellbeing), SDG 5 (gender equality), SDG 6 (clean water and sanitation), SDG 10 (reduce inequalities) and SDG 17 (partnerships for global health).² The Symposium identified a number of key actions to support CHWs in their role in attaining the SDGs, relating to political and financial support, a conducive policy environment, partnership among the range of health care providers and research.²

The wealth of published research experience concerning the role of CHWs provides the platform for planning and conducting studies to further build the evidence base in support of their role. For example, review of the CHW role in addressing neglected tropical diseases in sub-Saharan Africa highlights the need for future research on how to maximise the benefits of complementary interactions between the different disease control activities of integrated programmes.³ In building a strong evidence base on the optimal contribution of CHWs to achieving the SDGs, five key issues have been proposed for consideration: 1) promoting research on the role of CHWs across the range of priority health problems, including communicable diseases, maternal and child health and non-communicable diseases; 2) paying attention to research on cross-cutting enabling factors, for example education, accreditation and regulation, management and supervision, effective linkage to professional cadres, motivation and remuneration, and provision of essential drugs and commodities; 3) filling the research gap in understanding how to ensure the sustainability of programmes supported by CHWs, by using innovative national planning, governance, legal and financing mechanisms; 4) ensuring an emphasis on scientific rigour; and 5) using mixed methods research to answer policy questions beyond a narrow disease- or intervention-specific focus.¹

In providing the best possible evidence to guide efforts towards achieving the SDGs, Public Health Action welcomes research contributions on how CHWs can best play a role in ‘leaving no-one behind’.