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Community Health Workers: How Community-Driven Advocacy Changes COVID-19 and Health Decision-Making for the Long Haul

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The COVID-19 pandemic has catapulted front line health workers into the limelight. Across the globe, healthcare leaders, advocates and the general public are joining in well-deserved outpourings of gratitude from balconies to social media. While this appreciation for all of those at the front lines of care is welcome and important, the attention received by community health workers in particular may help ensure more stakeholders throughout health systems understand this cadre’s vital role in ensuring access to quality, community-based primary health care.

Community health workers serve as a critical link between tens of millions of patients and health systems, a connection ever more pressing amidst a global pandemic. Belonging to the communities they serve, community health workers understand community needs and often act as agents of change for their communities. Ensuring community health workers’ voices reach decision-making tables will establish a new normal that puts communities first and brings unparalleled insights to health policy making.

As we at the Johnson & Johnson Center for Health Worker Innovation set out to support one million nurses, midwives and community health workers by 2030, we adopted a human-centered approach to understanding and responding to the needs of individual health workers to thrive on the job. One of the key challenge areas we have chosen to prioritize is Respect and Recognition, since we understood that without representation, front line cadres are left out of critical health decisions. Our approach, therefore, is to elevate the voices of frontline health workers—particularly women—to give them the skills and platforms to represent their own issues and deliver their thinking, solutions and ideas.

At the Center, we partner with a number of organizations who have formidable track records in empowering front line cadres with the skills to advocate for their profession and communities. Three partners in particular have set the bar for recognizing the value and contribution that community health workers bring to the health system and are helping community health workers raise their voices.

Through the Johnson & Johnson Foundation’s almost 16-year partnership with Mothers2Mothers, we’ve supported the empowerment of Mentor Mothers, a special cadre of female community health workers who step forward to learn best health practices and bring those practices and additional health services into their local communities. Mentor Mothers themselves build recognition for their profession as communities’ trusted allies and provide a vital bridge between their communities and the primary health care system. This success was not developed overnight – indeed, it’s the outcome of a deliberate process that involves deep community engagement that has resulted in trust and mutual respect. Mentor Mothers are a pinnacle example of how recruiting, training and engaging local health workers delivers more than health outcomes, but economic empowerment and local leadership.

Women in Global Health has helped expand the dialogue on engaging under-represented voices in global health decision-making, especially for women, by recognizing the role of women on the front line and giving them access to a platform to reach policy makers. This month, with support from the Johnson & Johnson Foundation, Women in Global Health will launch COVID 50/50 Action Labs, an event series to provide context on how COVID-19 has exacerbated gendered challenges in the health workforce. Participants will hear from frontline experts on their perspective and ideas to support women in the health workforce, on topics from workplace safety and fair pay to women’s leadership.

For too long, conversations about community health workers have happened WITHOUT community health workers present, dramatically limiting real opportunities to hear the valuable perspectives of those working on the front line. Through a partnership with the Community Health Impact Coalition (CHIC) and other supporters, the Johnson & Johnson Foundation is supporting CHW Advocates, a training program to equip community health workers with the skills needed to be strong advocates and provide opportunities to be included in high-level decision making.

What is clear is that advocacy without representation is not what we need! We need the strong and powerful voices of our frontline health workers—particularly community health workers—at the relevant decision-making forums. These are the professionals who represent their communities and bring a rich understanding of what is needed to effectively bridge the gap between communities and the primary health care system. Now is the time we listen and seek their guidance—not just during the pandemic, but in every health decision.