African nations urged to prioritize Primary Health Care

________________

As global health systems face mounting challenges, experts call for urgent investment in primary health care (PHC) to ensure the foundation of healthcare systems remains strong, especially in Africa.

With millions of lives at stake, experts are sounding the alarm, urging African nations to prioritise PHC to achieve Universal Health Coverage (UHC).

Primary health care enables health systems to support a person's health needs – from health promotion to disease prevention, treatment, rehabilitation, palliative care and more.

This sector forms the backbone of healthcare systems and plays a critical role in the pursuit of UHC. However, despite its importance, PHC has long been underfunded and overlooked in many African countries, leaving countless communities without access to basic health services.

Community Health Workers (CHWs) serve as the frontline healthcare providers, particularly in rural and hard-to-reach areas.

African health experts in a panel discussion on professionalised Community Health Workers Mobility. This was at the Africa Health Agenda International Conference in Kigali Rwanda. (Photo by Lawrence Mulondo)

Experts argue that CHWs could save up to two million lives annually by improving access to essential health services. But to maximise their impact, experts call for better remuneration, comprehensive training, appropriate workforce tools and digital solutions for communication and data collection.

The mobility issue 

A major issue limiting the effectiveness of CHWs is the lack of mobility. In many parts of Africa, inadequate transportation options make it difficult for CHWs to reach remote areas, which hinders their ability to deliver timely health services.

Health experts are increasingly recognising the importance of mobility for CHWs, calling for innovative solutions to address these challenges.

During a session at the 2025 African Health Agenda International Conference in Kigali, Rwanda on March 3, 2025, Dr Landry Dongmo Tsague of the Africa Centre for Disease Control (CDC) emphasized the need for better mobility solutions.

“We need to invest in transportation and mobility for our community health workers to improve their productivity and health outcomes," Dongmo said. He argued that mobility should be a core pillar in community health systems.

The need for investment 

Dongmo also highlighted the critical need to invest in training, equipping, and protecting the health workforce.

He urged African leaders to prioritise domestic resources for healthcare, especially in the context of the challenges posed by diseases like HIV, malaria and tuberculosis.

“In Africa, $1 invested in the community workforce returns $10 in benefits for the community," Dr. Dongmo noted. He further called for a shift in how we view primary health care, suggesting that it should be reframed as a “priority health system,” which is essential for interacting with the majority of Africa’s population.

While giving a keynote address, Dr Anthony Gitau of Johnson & Johnson said investing in community healthcare is not just a cost, but an intervention that can reduce overall healthcare expenses by shifting focus from treatment to prevention. He explained that professionalising CHWs—including paying, supervising and supporting them—would not only promote economic recovery but also gender equity, as 70% of CHWs are women and 80% work without salaries.

Dr Gitau pointed out that the gap in community health systems in Africa stands at $4.4 billion, and there is a projected shortage of 6 million health workers by 2030. Many countries have committed to strengthening community health systems, but few have acted on these promises.

Gitau urged African governments to prioritise the allocation of resources to support salaried, skilled, and well-equipped CHWs.

Innovative solutions 

One successful example of improving mobility for CHWs comes from the partnership between World Bicycle Relief and Amref Health Africa. By providing bicycles to CHWs, this initiative has helped make their work more efficient and less tiring.

Maureen Kolenyo of World Bicycle Relief explained that bicycles are affordable, accessible, and environmentally friendly, making them an ideal solution for improving mobility in rural areas.

In countries like Uganda, Kenya, Tanzania and Rwanda, where CHWs often walk long distances to visit patients, the introduction of bicycles has had a profound impact.

A survey conducted in Zambia showed a 63% increase in the number of households visited by CHWs with bicycles, and 83% of CHWs used their bicycles to transport sick patients to health facilities.

The benefits of improving mobility for CHWs are far-reaching. With better access to communities, CHWs can deliver essential services like vaccinations and antenatal care. This has a direct impact on population health, improving outcomes for children and mothers alike.

Kolenyo concluded, “When community health workers can reach more people, it leads to improved health outcomes—children receive vaccinations, and mothers have access to skilled birth care.” With better mobility, CHWs are able to make a real difference in the lives of those they serve.