Community health workers in Zambia face major challenges due to their informal status. Most are unemployed and depend on incentives, yet they receive little or no compensation, making retention difficult and leaving many feeling exploited. They lack social protection, employment rights, and collective bargaining power, and are excluded from decision-making structures, resulting in poor coordination. Volunteers often work in unsafe environments without proper health and safety measures, exposing them to disasters and infectious diseases. According to WHO, volunteerism alone is unsustainable, as non-monetary incentives cannot meet basic family needs—highlighting the urgent need for fair compensation and formal recognition.

Community-based volunteers (CBVs) roles should be standardised and formalised within the health system by upgrading them to recognised grades like Community Health Assistants (CHAs)or Classified Employees (CEs). They also need an Association to advocate for their rights, promote their role, and build institutional capacity through social dialogue.

Recognising this, PSI affiliates in Zambia together with the Zambia Congress of Trade Unions (ZCTU) have been working to create the Community Health Workers Association of Zambia (CHWAZ).

At the meeting on 30 May 2025, the Interim Executive Committee and union leaders presented key Articles of the Association’s Constitution to the Ministry of Health. They outlined its objectives, planned activities, and strategies for collaboration with stakeholders, including the National Community Health Unit. The presentation also covered the legal framework for CHWs in Zambia, membership rights and obligations, governance structures, the role of the Community Health Workers Agent Committee, and measures to ensure the Association’s sustainability.

An important outcome of the discussions was that the Ministry of Health representatives agreed to issue a recognition letter to support the registration of the Community Health Workers Association of Zambia.

The Secretary of the PSI Zambia Chapter commended all parties for a productive meeting and expressed confidence that the Association’s Interim Executive Committee would work effectively with the Ministry of Health’s Community Health Unit, given their shared goals.

Latest Development: On 16 June 2025, the Ministry of Health provided the first signature for the recommendation letter, with endorsements from the Legal Department and the Human Resource Manager still pending. The registration paperwork is now close to completion.