Essential Workers. Temporary Funding. Why Are We Still Financing Community Health This Way?
About the session
Community health workers conduct home visits, identify sick children, support maternal care, manage chronic conditions, strengthen immunization efforts, and connect communities with health systems that can otherwise feel impossibly far away.
In many places where formal health systems are stretched, they are not an optional layer of care.
They are part of the infrastructure holding the system together.
So why do we keep financing them as if they were temporary?
Across countries and programs, community health workers can face short-term contracts, inconsistent or inadequate remuneration, limited career pathways, insufficient supervision and supplies, and uncertainty every time a grant cycle ends.
The Community Health Impact Coalition has distilled what professional community health workers need into four words:
Salaried. Skilled. Supervised. Supplied.
The simplicity of that formulation exposes a much bigger problem.
If we agree that community health workers are essential health infrastructure, then professionalizing the workforce cannot simply mean improving another CHW program.
It requires changing how the system is financed.
Organizations running community health programs can find themselves moving from grant cycle to grant cycle while trying to sustain a workforce whose value depends partly on continuity, relationships, local knowledge, and trust.
Governments may want to integrate CHWs into national health systems but face fiscal constraints, competing priorities, fragmented donor programs, or the practical challenge of moving thousands of workers onto sustainable public financing.
Funders meanwhile face their own question.
Are we funding community health programs, or are we helping countries build community health systems that can eventually survive without us?
Professionalization also requires more than salaries.
CHWs need training, supervision, supplies, functioning referral systems, useful technology, opportunities to progress, and meaningful participation in decisions about the systems they operate every day.
Digital infrastructure matters too. If the tools supporting community health workers are tied to individual projects, what happens when those projects end? What would it mean to build technology, data systems, and other shared infrastructure for community health with long-term public ownership in mind?
The goal is not simply to find another source of money for CHWs.
It is to ask what financing, governance, workforce policy, and infrastructure would be required to stop treating an essential part of primary healthcare as a succession of projects.
Discussion Group Leaders
Sage Ramadge is Director of Impact at Clinic+O, advancing sustainable, technology-enabled community health worker models that strengthen healthcare access and civic engagement.
Carmen Vilela is President at Red de Promotoras de Salud de Lima-Callao, advancing professional recognition, representation, and supportive policies for community health workers across Peru.
Francisco Dominguez is CHW Engagement Lead (Spanish) at Community Health Impact Coalition, advancing community health worker leadership, representation, and supportive policies across Latin America.
Courtney Evans Henke is Managing Director, Partnerships & Communications at Last Mile Health, building partnerships and communications that strengthen community health worker programs and expand access to quality healthcare.
Ruha Shadab is Director Strategy & Delivery at Financing Alliance for Health, advancing health systems and gender equity through strategic financing, policy, and systems-level approaches.
Smriti Shrestha is Director of Development and Partnerships at Spreeha Foundation, building partnerships that expand access to healthcare, education, and economic opportunities for women and communities in Bangladesh.
What to expect
A candid, practitioner-led conversation moving between the daily reality of community health work and the financing and governance systems behind it.
Drawing on experience across Africa, Asia, and Latin America, participants will examine what “salaried, skilled, supervised, and supplied” actually requires in practice, how governments can move toward sustainable financing for CHWs, what role international funders should play in that transition, and how technology and support systems can be designed to last beyond individual grants.
Carmen Vilela, President of the Network of Community Health Promoters of Lima-Callao, will bring a frontline perspective to a conversation about CHWs that too often happens without community health workers themselves.
Who this is for
This session is for community health workers and their advocates, global health funders and philanthropists, government health officials, community health program leaders, health financing specialists, digital health and public-goods practitioners, pandemic preparedness leaders, and anyone thinking seriously about how countries build durable primary healthcare systems.
What you will get out of it
A framework for understanding CHW professionalization as a workforce, financing, and governance challenge, not simply a program-design question
Practical perspectives on what salaried, skilled, supervised, and supplied community health work requires across different health systems
A clearer understanding of the challenges governments face in moving CHWs toward sustainable domestic financing and the role international financing can play in that transition
A conversation about how short funding cycles affect workforce stability and what longer-term approaches require from funders
Practical questions for designing digital tools, supervision systems, career pathways, and shared infrastructure that can survive beyond individual projects