This project is implemented by Public Services International in partnership with the Trade Union Solidarity Centre of Finland SASK.

Through this project, PSI affiliated unions in Zambia and Malawi have committed to ramp up their efforts to organize Community Health Workers.

Background Context

• In Malawi, community health workers (CHWs) operate within a structured government framework, where they are formally employed as part of the healthcare system. Making up more than half of all medical professionals in the country, these workers are essential to healthcare delivery. However, they face significant challenges including inadequate compensation, insufficient supervision, and limited access to necessary resources. While they do have some representation through trade unions, this representation primarily focuses on community nurses, leaving other CHW categories with limited advocacy support.

• The situation in Zambia presents a stark contrast, where the majority of CHWs are classified as volunteers rather than formal employees. These workers typically operate through NGOs instead of direct government employment, resulting in limited employment protection and job security. A significant challenge in the Zambian context is the complete absence of trade union representation for these healthcare workers, leaving them without a collective voice to advocate for their rights and working conditions.

To help unions analyze strategies to improve conditions, this project supported a study on Community Health Work in the region:

This project builds on work developed as part of a previous SASK project launched in 2020: Formalization of work in the health sector: Community Health Workers in Sub-Sahara Africa

Resources from the previous project are available here: