African governments and international development partners have called for increased domestic funding, better pay and formal recognition for community health workers as efforts intensify to deploy two million workers across the continent by 2030.
The call was made on Wednesday at the opening of a three-day high-level forum on community health workers in Abuja, where participants stressed that Africa could struggle to achieve Universal Health Coverage without a well-trained, adequately equipped and sustainably funded workforce.
Minister of State for Health and Social Welfare, Dr. Iziaq Salako, disclosed that Africa had about 1.36 million community health workers as of May 2026, leaving the continent short of its target of two million by 2030.
He said, “Only 68 per cent of African Union member states formally recognised community health workers as part of their national health workforce, while only about half paid them through government budget lines.”
Salako added that about 85 per cent of African countries still depended on donors to finance at least half of their community health worker programmes.
He said, “Estimates indicated that about $4.3 billion annually would be required to support the workforce, with an estimated $19 in economic and social returns for every dollar invested.”
The minister said Nigeria had approximately 83,000 community health workers and was taking steps to strengthen primary healthcare through the Health Sector Renewal Investment Initiative, national workforce planning and improved domestic funding.
He urged participating countries to develop fully costed implementation plans, establish measurable targets and secure funding commitments that could be reflected in their national budgets.
Salako also called on development partners to align their support with countries’ priorities, work through existing national systems and provide reliable long-term assistance without shifting governments’ financial responsibilities to donors.
Representing member states, Dr. Richard Kabanda of Uganda’s health promotion sector described community health workers as essential to immunisation, maternal and child healthcare, screening for non-communicable diseases and community outreach programmes.
He advocated their formal inclusion in national health workforce frameworks, alongside standardised training, effective management structures and continent-wide policies to improve healthcare delivery.
A UNICEF representative, Helga Fogstad, said community health workers should serve as the first point of contact for patients rather than being treated as the last mile of healthcare delivery.
She identified fair wages, supportive supervision, access to essential supplies, digital tools, career development and greater community ownership as priorities for strengthening the workforce.
Fogstad also reaffirmed UNICEF’s continued support for incorporating community health workers into national health plans, budgets and monitoring systems.
Juliet Odogwu of Africa Frontline First (AFF), representing its champion, former Liberian President Ellen Johnson Sirleaf, reaffirmed the organisation’s commitment to the African Union’s target of two million community health workers and the professionalisation of 200,000 workers by 2030, in partnership with Africa CDC.
She said more than 100,000 workers had been formalised since 2023 through partnerships involving governments and development organisations. She also urged countries to prepare investment proposals and sustainable financing strategies to support the expansion.
The Head of Delegation of the Red Cross/Red Crescent, Dr. Asha Mohammed, highlighted the contributions of community volunteers to the early detection of health threats, risk communication and emergency response.
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She called on governments to integrate community-based workers into national healthcare systems and strengthen cooperation and trust between health authorities and the communities they serve.
Meanwhile, Amref Health Africa, in partnership with the Mastercard Foundation, presented research findings involving approximately 155 community health workers and young people across five African countries.
The organisation’s representative, Mieko McKay, identified delayed salaries, limited career advancement and inadequate institutional support as major challenges affecting staff retention.
“In Malawi, some health surveillance assistants reportedly experienced salary delays of up to three months,” she said.
McKay stressed that expanding recruitment alone would not solve workforce shortages unless governments also created better working conditions to retain personnel.
The Director-General of the Africa Centre for Disease Control, represented by Prof. Aliko Baba Ahmed, called for stronger health systems, improved emergency preparedness, reliable domestic financing, expanded digital healthcare and increased local production of medicines and vaccines.
He cautioned against excessive dependence on foreign donors, arguing that health sovereignty required African countries to take greater responsibility for financing and managing their healthcare systems while maintaining equitable international partnerships.
The three-day forum is expected to conclude with an Abuja roadmap and commitments designed to accelerate progress towards Universal Health Coverage across Africa.