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New Paper: Healthcare Services for Rural Sub-Saharan Africa Within Reach


A new paper published in the Bulletin of the World Health Organization has determined that providing rural sub-Saharan Africans a close-to-client health system by paid, full-time community health workers by 2015 would cost $2.6 billion per year, or just $6.86 per person covered by the program.

The paper, authored by Gordon McCord at the University of California, San Diego and Prabhjot Singh and Anne Liu at Columbia University’s Earth Institute, details an analysis of the financial cost of a planned expansion of community health worker (CHW) programs across rural sub-Saharan Africa with the goal of reaching full coverage, or around one million CHWs by 2015. Government health programs and non-governmental organizations, like the Millennium Villages, have successfully piloted CHW programs in many communities across Africa. These efforts have demonstrated overwhelming evidence that community-based interventions — implemented by CHWs — are an effective platform for extending health care delivery and improving health outcomes. Moreover, CHWs provide the rural poor a critical link to the broader healthcare system of doctors, nurses, hospitals and clinics.

Launched in January, the One Million Community Health Workers campaign has seen an outpouring of support from African leaders, such as Rwandan President Paul Kagame, multilateral organizations and corporations, such as Novartis, which has pledged $1 million to the program.

Read the paper here: http://www.who.int/bulletin/online_first/12-109660.pdf

Key findings:

  • At a rate of 1 generalist for every 650 rural Africans and of 1 childbirth specialist for every 3500 Africans, the average annual cost of CHW system ramp-up across Africa is around US$ 2.6 billion, or US$ 6.86 per person covered by CHW services, or US$ 2.72 per total population.
  • It will take an average of US$ 3750 annually to train, equip and support each CHW between 2012 and 2015.
  • These results suggest that the costs of the core elements of a CHW subsystem are a fraction of the costs of primary-health-care services overall.

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