Across the developing world, rural communities’ health care services are often non-existent or inaccessible. In Zambia today, there is one doctor for every 23,000 people, well above the World Health Organization’s recommended ratio of one doctor and nurse to 7,000 people for Africa. As a result, people die from preventable or curable ailments because they fail to get medical assistance in time, unable to travel the long distance to the nearest medical facility. For example, Zambia’s maternal mortality ratio is one of the worst in world because over half of all births occur at home or with an unskilled birth attendant present.
To address the shortages of health care workers, the Clinton Health Access Initiative (CHAI), with support from the UK Department for International Development (DFID), has been supporting the Government of Zambia since 2007, and in 2012 that work expanded to helping train health care workers, called Community Health Assistants (CHA). After a year of training in the classroom and in the field, CHAs return home to bring basic health services to their remote, rural communities.
A year ago, the first class of CHAI-trained CHAs finished their training and went home or to other rural areas to provide health support. Today, I met two of those original three hundred graduates, Doubt Mbula and Ben Suunyisa. They live and work in the community of Sialwiindi, near Livingstone, where they each visit roughly 130 homes every year to first understand the health needs and then to provide health services to families living within their community. They help families like Timothy Sianisindo’s and make sure that the family has gone for HIV testing, is sleeping under bed nets to prevent malaria, and that his wife is getting the pre and antenatal care she needs to ensure a healthy pregnancy. They also help families understand the benefits of pit latrines, washing their hands after using the latrine, separating animals from where they live, ensuring cooking happens outside – to help prevent diarrheal diseases, respiratory infections and other ailments. By providing critically-needed health care and empowering people over their families’ public health, they have an enormously positive impact. It is also clear the work has a profound impact on Doubt, Ben and other CHAs – they are rightly proud of the diseases they are helping prevent and the people they are helping lead healthier, stronger lives. They even wrote (and sang to us) a song about their work!
When CHAs aren’t in the field, they work at health posts like the one in Manyemunyemu, which serves more than 3,000 people. Nurses like Rudo M’dala and CHAs like Melody Beene work together to provide maternal and child health services, administer vaccines, treat malaria, respiratory infections and diarrhea, as well as a range of other basic health services to the community. With help from such wonderfully talented CHAs and nurses, Zambia’s maternal mortality is declining.
Over the next five years, CHAI will support the training of approximately 3,000 Community Health Assistants. We are honored to partner with the Zambian government and excited about the work we are doing to ensure that sustainable health – and health care – of rural villages for generations to come.