S P E C I A L I S T I N S I G H T

As a community-focused organisation , the non-profit tries to look at everything it does through an equity lens .

“ We take a people-first approach to make sure that no one is left behind in the communities that we serve , regardless of their socio-economic status , their gender , literacy levels or geographical location ,” said Diana Mukami , Digital Learning Director and Head of Programmes at Amref ’ s Institute of Capacity Development .

Over six decades , the organisation ’ s strategy and approaches have continued to evolve . Its current strategy ( 2023 – 2030 ) focuses on people-centred health systems for sustainable primary health care ( PHC ) and addressing social determinants of health to increase equitable access to services .

“ Climate change has a huge impact on health services ,” Mukami said . “ And so , to continue our mission of increasing access to quality health services at a community level , we have to take a one ( human , environment and animal ) health approach .”

The organisation also works with governments and healthcare bodies across Sub-Saharan Africa . To which Mukami added : “ We support government efforts to find scalable and sustainable fit-for-purpose solutions to address health challenges in Africa .”

To enable this mission , the NGO recently partnered with Cognizant to enhance the data analytics and reporting capabilities of its digital tools . The project – funded by GSK – has allowed Amref to enhance its digital tools to get better visibility and understanding of the data they capture , to improve training and the quality of services health workers provide .

Here , Mukami tells us more .

What does your day-to-day look like at Amref ?

As Digital Learning Director and Head of Programmes , all my work involves engaging with different stakeholders . Since we primarily work through governments and Ministries of Health , I often engage with officials and regulatory bodies – such as health professional regulators – to understand the needs and priorities of the different countries we work in .

I work with these stakeholders to design programmes that are responsive to government priorities . Working with governments and their priorities ensures that there is better efficiency in use of resources and no duplication of efforts .

We take a human-centred approach to the design of programmes , with each programme tailored to the individual needs of different communities . For example , when designing programmes around female genital mutilation / cutting ( FGM / C ) – which is a problem faced across many countries in Africa – we take a cross-sectoral approach to understand more about this practice , what drives it and how it can be tackled . The design phase of such a programme would therefore include stakeholders like the women and girls , the cutters , the government ( health , education , social services , legal ), men and boys , opinion leaders and religious leaders .

Can you tell us more about the skill shortage Africa is experiencing in healthcare ?

It is projected that by 2030 , there will be a health worker shortage of over 6 million within Sub-Saharan Africa . It ’ s already at 4 million and with the projected population increase , the numbers and skills gap will widen . The shortage also considers the distribution of healthcare workers – many are likely to remain in urban areas , which will negatively impact more rural communities where the largest proportion of the population lives . So , there has to be an equitable distribution of workers within and across the different countries .

The World Health Organisation describes health systems as six core building blocks : service delivery , health workforce , health information systems , medical products , vaccines and technologies , health system financing and leadership and governance . And while we do need these elements , none are possible without the workforce .

At Amref , we believe the seventh health system building block is the community or people . To better serve communities within the households , we are therefore advocating for an increase in community health workers . Evidence shows that a large proportion of Community Health Workers ( CHWs ) are female , and yet they carry out unpaid work , meaning there is need to advocate for the formalisation and remuneration of this critical group of health workers . These are people who largely volunteer from within their communities and are trained by government organisations , like us , to provide services , like health education and prevention . They ’ re also able to support early detection of diseases , such as breast cancer , and promote healthy practices within their societies . We are one of the advocates seeking to have CHWs to be made part of a formal health system and there is a lot of evidence about why they ' re important . For instance , referrals for pregnant women to deliver their babies at health facilities and immunisation campaigns rely heavily on CHWs and the trust that communities have in them .

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