Frontline Workers Seek Voice
By Francis Maingaila ♥️
Lusaka, Zambia 24 --- (26-05-2026) ---
The Community Health Workers Association of Zambia (CHWAZ) is pushing for formal recognition, with growing calls for government to speed up its registration process.
The National Coordinating Committee (NCC) of PSI affiliates in Zambia, supported by partners under Public Services International, has urged authorities to urgently register CHWAZ, saying delays are affecting coordination and slowing improvements in health service delivery.
Nearly 1,000 community health workers have already joined the proposed association, reflecting strong demand for a unified national platform.
Community health workers remain a critical part of Zambia’s primary healthcare system, supporting maternal and child health, disease prevention, HIV services, early disease detection, and community outreach, particularly in rural and hard-to-reach areas.
However, many continue to work under informal arrangements, facing low or irregular pay, limited job security, and inadequate training and equipment.
He said formal recognition would strengthen coordination in the health sector and improve engagement between community health workers and authorities.
“Registering the association will strengthen coordination in the health sector and improve how community health workers engage with government,” Mr Malema said.
He added that delays in registration are already affecting dialogue between CHWs and government institutions, slowing progress on improving working conditions.
Malema further said formal recognition would strengthen labour standards, improve social dialogue, and enhance cooperation with development partners.
He urged the Ministry of Health Ministry of Health Zambia to fast-track the process, saying it would directly improve service delivery nationwide.
He noted that community health workers operate at grassroots level where many health challenges are first identified, stressing that government cannot be everywhere at once.
Malema said a formal association would help organise CHWs into a structured body capable of communicating community health needs more effectively to authorities.
He added that many community health issues go unreported, and an organised structure would help bridge that gap through coordinated reporting into the health system.
He said CHWAZ aims to ensure the voices of community health workers are heard and that their concerns are taken to decision-makers for action.
He further explained that the association seeks to protect the interests, rights, and welfare of community health workers while promoting decent working conditions.
Malema added that CHWAZ also aims to strengthen collaboration with the Ministry of Health, provincial health structures, neighbourhood health committees, and facility-level committees to improve service delivery.
He said the association will advocate for better incentive schemes, improved conditions of service, and monthly stipends for community health workers.
Malema also highlighted the role of CHWs during public health emergencies such as cholera and COVID-19, where they supported frontline response efforts.
He said many have served for over a decade under difficult conditions with limited support, despite being central to community health delivery.
He stressed that CHWAZ is not seeking confrontation with government, but partnership and recognition to strengthen the health system.
He expressed confidence that formal recognition would benefit both workers and the country’s healthcare system.
He said many still work under informal or semi-formal arrangements, with low and irregular stipends, limited job security, and inadequate training and protective equipment.
Moonga said the lack of formal recognition is weakening service delivery and affecting the overall health system.
“Recognising community health workers is not only about workers’ rights, it is about strengthening Zambia’s primary healthcare system,” he said.
He added that CHWAZ has been formed as a platform for engagement with government and stakeholders, not as an opposing body, but as a partner in strengthening healthcare delivery.
Moonga called for urgent government action on registration, saying delays are affecting coordination and communication in the health sector.
He said the association is ready to work closely with the Ministry of Health and other stakeholders to improve community-based healthcare delivery.
She said many continue to serve without adequate pay, despite being on the frontline of essential community services.
Tembo said CHWs remain committed to their communities but are constrained by lack of recognition and absence of a formal structure.
She also urged government to speed up registration of CHWAZ, saying formal recognition would give workers a unified platform to engage authorities and strengthen service delivery.
He said once approved, the association will organise community health workers into a structured body to represent their interests.
He added that the initiative has been widely welcomed as long overdue due to the absence of a unified platform.
Sinkala said CHWAZ will improve coordination by linking community health workers with government health structures and ensuring their concerns are communicated to relevant authorities.
He noted that it will work with the Ministry of Health Zambia and existing coordination units to align community health work with national health programmes.
He said the association will establish structures at facility, district, and provincial levels to strengthen coordination nationwide.
Zambia’s health system remains heavily dependent on community health workers due to shortages of doctors and nurses, particularly in rural areas.
At an advocacy event organised by the National Coordinating Committee of Public Services International, Elena Konopelko said CHWs are central to primary healthcare but remain under-supported and not fully integrated into the system.
She noted that CHWs provide immunisation, maternal and child health care, health education, patient follow-ups, and disease surveillance, yet most still operate outside formal employment structures.
Zambia has about 1.9 nurses per 1,000 people and only 0.3 doctors per 1,000 people, highlighting a serious workforce shortage.
Konopelko said the community health system is fragmented, with workers operating under government programmes, NGOs, churches, and donor-funded initiatives, leading to overlapping roles and weak supervision.
She added that although the government introduced the Community Health Assistant programme to professionalise the workforce, coverage remains limited, with only about 2,500 of 40,000 CHWs formally employed.
Most others remain informal, relying on small stipends instead of salaries and facing poor working conditions, including lack of job security, transport challenges, and limited career progression.
Konopelko said there is a clear gap between World Health Organization (World Health Organization) guidelines and implementation in Zambia, with policies mainly benefiting Community Health Assistants rather than the wider CHW workforce.
Donor funding, she added, accounts for nearly half of health financing, contributing to fragmentation and weak coordination in service delivery.
She called for stronger organisation of CHWs and improved coordination between government, unions, civil society, and development partners, stressing that CHWs remain essential to Zambia’s health system despite persistent challenges.
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