As developing countries cope with Covid-19, strong community health resources provide a lifeline

A community health worker in Tanzania provides counseling to community members.

For years, the people of Sabagreia, in Bayelsa State, Nigeria, had nowhere to turn for reliable health care, as the government health center had long been closed. When Pact began working in Sabagreia to prevent mother-to-child HIV transmission, the shuttered health center immediately stood out as a problem. Pact provided training to the local Community Development Committee on how to mobilize resources and demand accountability from the local government. Soon a health worker was posted in Sabagreia, and then more. Equipment and supplies quickly followed.

In Si Pin Thar, a remote village in Myanmar’s Meikhtila township, there was a time when women never sought prenatal care. This changed after Pact and its partners, with funding from USAID, trained thousands of “community health defenders,” mostly women volunteers who learned the basics of nutrition, hygiene and safe pregnancy and childbirth, as well as how to diagnose and treat common childhood illnesses. 

These are just two examples of the many ways that international NGOs have been working for decades in partnership with local organizations, governments and communities to build strong community health systems from the ground up, including health infrastructure, health knowledge and networks of health organizations and volunteers working together. This work has been essential in helping developing countries fight HIV and AIDS, maternal and newborn mortality, diarrheal diseases, malnutrition and more, and today, it is also playing a pivotal role in helping communities around the world respond to Covid-19. 

Last year alone, Pact’s work helped more than 1.7 million people gain access to improved health and social services, and we strengthened more than 200 health systems. Like those in Myanaung township and six other vulnerable areas in Myanmar. Through the USAID-funded Essential Health project, Pact and our partners helped communities form Village Health Committees. The Committees, made up of volunteers and local health care workers such as midwives, help villagers know when to seek emergency care. They also help villagers get access to that care through Community Health Funds. With contributions from every household, the Funds support emergency referrals and transportation needs to reach care quickly. These local systems are already providing life-saving action for communities far from hospitals, clinics and emergency health services, and they will be critical for disseminating information on Covid-19 and helping villagers prevent and treat the disease.

We didn’t know it at the time, but clean water infrastructure and hygiene training that our programming has helped provide in recent years – from Tanzania to Nepal – is now proving even more vital. Before Pact’s program to combat stunting in Tanzania’s Songwe region, people didn’t think handwashing was important. They didn’t know how to properly wash their hands and often didn’t have access to handwashing facilities in public spaces. Today, with support from UNICEF, water is available for handwashing at community meetings and at the local market. And because of a network of community health workers, people know proper handwashing techniques—one of the most basic and critical tools for preventing the spread of Covid-19.

Through these projects and other community health work, we have seen the value of strengthening local community systems and their capacity to cope with endemic problems. While no single organization or government alone can adequately confront an emerging health crisis, these strong community health systems are well positioned to support a society-wide response to complex issues like Covid-19. They can foster sharing of information, identify gaps in coverage, scale-up proven approaches and speed innovation and adaptation. They can amplify the voices of the most vulnerable and ensure that no one is left behind. All necessary in the global response to Covid-19, and we’re already seeing it today.

In Ukraine, Pact’s local partners of women’s rights organizations are retooling to set up hotlines to support women at risk for domestic violence for whom home is not a safe shelter. In Eswatini, trained home visitors have shifted to conducting phone check-ins with vulnerable families. In addition to making sure children living with HIV are still able to access their medication, these volunteers are calling with guidance on how to prevent the spread of Covid-19 and quickly build makeshift home handwashing stations. These are just a couple of examples of community-driven adaptations to Covid-19 that are emerging from community health systems built by our programming. And Pact is just one of many international development organizations that have helped lay such foundations. 

As community organizations, leaders and volunteers rise to the occasion of Covid-19, their efforts will no doubt play a significant role in flattening the virus’s curve and preventing its resurgence. This will be true for our next global health emergency, too. Now more than ever, we must continue to support and invest in strong community health systems. They are a lifeline the world can’t afford to lose.