Experts: Community health promoters vital for Africa's primary healthcare

Prevention of diseases through the primary healthcare system dominated health talks, with African states asked to grow community health promoters for its success.The talk on community health promoters has been recognised as engines to actualisation of primary health, which African states are banking on amid freeze on foreign aid that remains uncertain with signing of executive order by U.S. President Donald Trump.Health experts, policymakers, and stakeholders recognised community health promoters as an engine to actualisation of primary healthcare.

The agenda dominated the ongoing Africa Health Agenda International Conference  (AHAIC) 2025 in Kigali, Rwanda, meant to help find solutions for health issues affecting the African continent and making states self-sufficient.Dr Addis Tamire, Senior Director for Integrated Health System Investment at Amref Health Africa, acknowledged that community health workers fill critical gaps while delivering quality, affordable services closer to underserved communities.Tamire said the workers have been key in containing pandemics like Ebola in West Africa and the Covid-19 outbreak in the African continent and are also key in stopping epidemics.“African Governments and other stakeholders need to prioritise investing in the scale up of integrated community health systems that ensure that Community health workers are skilled, supervised, supplied, compensated, and fully integrated in the health system,” said Tamire.Tamire observed that states should guarantee gender responsive systems to ensure equitable pay, career advancement, and workplace protections for Community health workers.The official emphasized that in line with the commitments made thorough African leadership meeting declaration, the Abuja Declaration, and the Monrovia to Action, the Africa CDC New Public Health order acknowledges the need to increase domestic health financing, strengthening primary health care and ensuring the formalization and sustainable support of community health workers.Ironically, as states bank on Community health workers to actualise Primary Healthcare, there is less budgetary allocation for their support.In some states, there is clear structures in operation of community health workers who are paid, whereas in some, they remain volunteers, pushing primary healthcare at the fence.Kenya is among the countries applauded for better structures of community health providers who are paid a stipend of Sh5,000 monthly, under shared responsibility between county and national governments.Joan Amambia, a community health promoter from Vihiga County in Kenya, shared her experience in the African summit, saying integrating the workers within the healthcare system has eased their operation, including pay that has boosted their morale in the delivery of her role.Though little, the Sh5,000 stipend she says motivates her to give her best services to households, referring those in need of more care to facilities.“I am motivated, but hope for the best pay in future. I work hard because I know I shall also get something in return. The job also makes me satisfactory because I train pregnant women on taking care of pregnancy and ensuring the households are healthy,” said Amambia.Amambia has been working with the community since 2010, prior to being aligned into the health system in 2023 as a community health promoter, currently covering at least 130 households.Ouma Onyango, a senior advisor for research and strategic communication at Pathfinder International, said African states can attain primary healthcare by critically analysing their health needs to have them aligned within their respective health system.“Localisation of country needs is key as a people and continent because countries have their different needs,” said Onyango.Living Good is among the organizations that has trained and supplied digital tools and equipment to healthcare workers in Bukina Faso, Kenya, and Uganda for the past 16 years.Last year, the organisation worked with at least 10,000 community health workers by supplying them to deliver treatment to about 2.5 million sick children, and reached out to 100,000 pregnant women, by ensuring they attend ANC and deliver in hospitals to avert maternal and child deaths.Additionally, experts pleaded with states to strengthen leadership and governance through aligning community health workers' agenda towards national priorities, reducing fragmentation, and ensuring genuine commitment towards accountability for community health workers.