Investing in Community Health, Fighting COVID-19, and Achieving UHC 

2019 ended on a high note for the global health community when United Nations Member States adopted the Political Declaration on Universal Health Coverage (UHC). An ambitious and comprehensive document, leaders from around the world agreed that everyone should have access to quality and affordable health services. And, importantly, the document reflected a consensus that scaling up the number of competent, skilled and motivated health workers able to deliver essential care—including community health workers (CHWs)—was key to accomplishing this critical goal at scale.

Since the adoption of the Political Declaration in September, the global health landscape has shifted dramatically. No matter where in the world we live, we are all impacted by the COVID-19 pandemic. Although we’re in the midst of a global health emergency, it’s actually more important than ever that we prioritize and accelerate the investments in health systems and frontline health workers to achieve UHC. 

CHWs are critical to both the COVID-19 response and achieving UHC. In Uganda, where I work with Living Goods, CHWs—or Village Health Teams as we call them—are essential frontline health workers providing primary health care to the last mile. It is imperative that maternal and child health services continue as we fight COVID-19. We know the disruption of care can be an unintended casualty from past outbreaks like the 2014-2015 Ebola outbreak in West Africa which resulted in a 50% reduction in access to healthcare services.

Since March, my colleagues and I at Living Goods have been working closely with the Ugandan Ministry of Health to support a coordinated response to COVID-19 that integrates CHWs into its design and implementation. Vital to the response is ensuring that CHWs and all other frontline workers are equipped with appropriate personal protection equipment (PPE) including masks, gloves, and hand sanitizers so that they can safely continue to provide essential health services and contribute to the pandemic response. Recognizing the importance, Living Goods has worked with Minister of Health, Dr. Jane Aceng, in procuring PPE and creating a strategy outlining the role of Village Health Teams, which includes delivering services using “no touch” protocols where possible. 

“Village Health Teams (VHTs) are trusted members of the community connecting populations to primary health care services that are essential for attaining UHC. It is important to support our VHTs in fighting COVID-19 as well as maintaining essential health service delivery in communities.” Dr. Aceng stated.  “The Ministry of Health is committed to ensuring VHTs are protected with PPE so they can help our frontline health workers prevent, detect and respond to COVID-19 and future health emergencies.”

Strengthening CHWs and health systems now will lead to progress on the road to UHC and preparedness for future pandemics in the years to come. Innovative partnerships are coming together, and new technology is being leveraged to improve the collection and analysis of data, and to strengthen digital systems that improve remote service delivery.

“In such very difficult and challenging times, we need to look beyond budgets and ensure access to health care for all,” said Dr. Yonas Tegegn Woldemariam, Uganda Country Representative at the World Health Organization (WHO). “At WHO, we are working with Government Ministries of Health around the world and partners to get practical solutions to enable us deal with the COVID 19 pandemic. We are also working on using predictive analytics to think proactively about the needs of governments tomorrow with a focus on building a sustainable health care system for all as we work towards Universal Health Coverage.”

We have months and even years ahead of us in combatting COVID-19, but I am optimistic. We all must remember our pledge to UHC. With the commitment of decision-makers and funders and supportive policies that invest in health systems strengthening, we will be better positioned tomorrow than we are today. By working together, we can overcome this pandemic and ensure everyone, everywhere, has access to quality and affordable health services.

Dr. Diana Nambatya Nsubuga
Africa UHC Co-Chair
Deputy Director, Living Goods Uganda

The views expressed in this blog are those of the author and do not necessarily reflect the views of PHCPI , WONCA, AfroPHC, or their members and partners.