Today while in Zambia, President Clinton and Chelsea met Benny Siinyisa, a Community Health Assistant, who is one of two people providing care for a rural community of 6,000 people. Clinton Health Access Initiative Human Resources for Health Program Manager Emily Heneghan Kasoma shares with us what it is like for Benny and other Community Health Assistants to provide care to some of the most rural communities in Zambia.
It is 6:00 a.m. Benny Siinyisa gets on his bike to begin a two hour ride over rough terrain that includes sandy pits, rocky slopes, and the occasional encounter with a range of African wild animals. Eventually he reaches his destination, a village in his region that likely has never been visited by a licensed health worker.
Benny is a Community Health Assistant serving in the area surrounding Zambia’s Kafue National Park. He, along with 306 others recently deployed Community Health Assistants (CHAs), make up Zambia’s newest cadre of trained health workers. These CHAs were trained to serve the people living in the most rural and remote parts of the country where they had no access to regular health care.
The CHAs are the centerpiece of the Zambian government’s new Community Health Worker Strategy, which proposes a target of 5,000 CHAs trained by 2020. The development of this strategy, as well as the training and long term scale up of this cadre, are being co-driven by Clinton Health Access Initiative and the government.
The CHAs are expected to know the culture and language of the people they serve so that they fully understand their health needs. To ensure this, each CHA is nominated by their local community, trained for one year on a range of preventative and curative health topics, and deployed back to the same community to help improve the health of their people.
Benny, for example, spends one day each week working at his local health post. He and one other CHA serve a population of about 6,000 people. They are the only trained health workers posted to the facility, and provide treatment for malaria, diarrheal diseases and respiratory infections, testing for HIV, among other critical, life-saving services. The other four days a week are spent taking these services directly to the homes that are within his designated area. When visiting the homes, he also provides a great deal of education about proper sanitation, reproductive health, and other things.
In the first home he visits, the wife just had a baby. She wants to wait before having more children, so he provides her with oral contraceptives from the kit of medications he is licensed to prescribe. He also reminds her to come for the children’s clinic next week to get the next round of vaccines for her child. One year ago, when Benny began his work as a CHA, only 5-10 women would bring their children for this clinic. Today, 40-50 women and their children visit the clinic each week.
For the men in the household, he explains more about the benefits of getting circumcised. Although this practice is considered taboo in his area, since he started explaining the benefits to males on this practice, over 200 men within his catchment area have gone for the procedure.
Following these discussions, Benny walks with the family around their home. He notices that they have constructed a proper pit latrine and hand washing station since the last time he visited them – something that they tell him was because of the education he provided. They also tell him that all family members have seen a reduction in diarrhea since they started using these facilities.
As their visit comes to an end, Benny congratulates them on a job well done. He has five more households that he plans, so he must be going. But he leaves them with quality medical advice and treatment, as well as the knowledge that they have been able to improve the health of their family with the education he has provided.