Community health workers – the unsung heroines

Barriers to health services

The barriers to access of health care services in pregnancy and childbirth are often insurmountable for women around the world. Despite efforts to improve referral networks and the quality of services, women continue to suffer preventable pregnancy complications with catastrophic outcomes at alarming rates.

In the face of immense challenges, community health care workers are dedicated to providing care and support to the most vulnerable. In many countries, these workers are predominantly or exclusively women, working tirelessly with little formal education or training and for nominal compensation.

The potential of community health workers

In this series we focus on the potential of such community health workers to identify and care for women with pre-eclampsia. The findings demonstrate mixed levels of knowledge of pre-eclampsia; nevertheless, a possibility for task-sharing in combination with appropriate clinical training and supervision.

“If they have high blood pressure, if it’s something that we can still manage, they will accept the treatment” Community health extension worker, Nigeria

Task-sharing with community-based providers could go a long way in building community resilience and bridging the gap in human resources. We were encouraged to hear of widespread support for community health workers by the communities they serve and the health system.

Results presented in these seven manuscripts may be used to guide task-sharing initiatives and health worker training regarding pregnancy complications.

This supplement represents the second set of manuscripts from extensive Feasibility studies conducted in Pakistan, India, Nigeria and Mozambique. These results have been invaluable to inform the subsequent cluster randomized control trial – Community Level Interventions for Pre-eclampsia (CLIP).

On behalf of all the researchers involved in the Community Level Interventions for Pre-eclampsia Feasibility work, our deepest gratitude goes out to all communities who warmly welcomed us into their homes and hospitals.

In this supplement we honour the relentless efforts of Community Health Extension Workers in Nigeria, Agentes Polivalentes Elementares in Mozambique, Lady Health Workers in Pakistan, and Accredited Social Health Activists and Auxiliary Nurse Midwives in India. Without these unsung heroines (and heroes) the lives of many more mothers and infants would be lost.