This paper provides an outline of the primary healthcare (PHC) initiatives and the situation of CHWs in 11 countries in Sub-Saharan Africa and the MENA region. It outlines the challenges and possibilities for decent work and encourages social dialogue to improve the working conditions of CHWs in this region.

The objectives are:

• To describe the PHC initiatives and in 8 of the 11 countries, also describe the situation of CHWs in terms of:

  • - their programme initiatives, successes, challenges, and suggestions for the way forward

  • - Present two major examples of precarious work of CHWs and female-held healthcare profession including contestation and social dialogue of CHWs

• To outline the recent primary healthcare policies by African nations

• To provide an assessment of the ILO regulations relating to CHWs by identifying related regulations, gaps, and proposals for further elaboration