Empowering Nepal’s Community Health Workers

Basanti Maharjan and Gita Devi Thing, two Female Community Health Volunteers (FCHVs) from PSI affiliates HEVON and NEVA in Nepal attending the 112th session of the ILO International Labour Conference and met with Abigail Hunt from the UK Trade Unions Congress for a fruitful experience sharing session.

Community Health Workers in Nepal are tasked with over 80 different responsibilities, ranging from basic healthcare services to maintaining social harmony within their communities. Despite their indispensable contributions, CHWs face severe exploitation: they work without specific hours or adequate compensation. This situation is nothing short of wage theft, particularly considering that the CHW workforce is composed entirely of women. These dedicated individuals are on call 24/7, constantly ready to serve their communities.


Volunteer Community Health Worker in Nepal want to be recognised as public health care workers.

Gita Devi Thing Paudel, NEVA, Nepal @ ILC2024

Bureaucratic Hurdles

When CHWs submitted a charter of demands, the response from the government was disappointing. The three tiers of government – central, provincial, and local – pointed fingers at each other, avoiding responsibility and leaving the issues of CHWs unresolved. This bureaucratic deadlock highlights the need for a unified and decisive approach to support these essential workers. 

Unique Selection Process

The selection of CHWs in Nepal is uniquely community-driven. Candidates are chosen by active mothers' groups within the community, with the criteria that they must be married and have children. This grassroots approach ensures that CHWs are deeply connected and committed to their communities, but it also underscores the need for formal recognition and support. 


Volunteer Community Health Workers want to be recognised as public health care workers. #ILC2024

Basanti Maharjan, HEVON, Nepal @ ILC2024

Recent Wins

Despite these challenges, there have been some significant victories for CHWs in Nepal. For instance, 109 CHWs have been enrolled in the national social security scheme. Additionally, there has been a 100% increase in their transport allowance, and health insurance coverage has been extended to CHWs and their families. These improvements are a testament to the persistent advocacy and resilience of CHWs and their supporters. 

Insights from TUC

Abigail Hunt shared valuable insights, emphasizing that in many regions, care work is not considered volunteerism. All health workers are covered under the National Health Coverage (NHC) scheme, ensuring they receive the support and recognition they deserve. This model provides a valuable benchmark for how Nepal might better support its CHWs.

The meeting with Abby underscored the critical need for systemic changes to support Community Health Workers in Nepal. While there have been some recent successes, much work remains to be done to ensure these vital workers receive the recognition, compensation, and support they deserve. By addressing these issues, we can help create a more equitable and effective healthcare system that truly serves the needs of all its citizens.