Africa needs $4.3bn a year for community health workers, ministers say
- African health ministers and partners met in Abuja to push for two million community health workers by 2030.
- Nigeria's health minister said the continent needs about $4.3bn yearly, with $19 returned for every dollar spent.
- Nigeria has roughly 83,000 to 93,000 such workers for more than 240 million people, officials said.
African governments and their development partners opened a three-day meeting in Abuja on Wednesday with a clear message: the continent's plan to have two million community health workers by 2030 will not happen without steady money and proper pay.
The Minister of State for Health and Social Welfare, Dr Iziaq Salako, put the yearly bill at about $4.3bn. Every dollar spent on these workers, he said, is estimated to bring back about $19 in economic and social gains.
Community health workers are the people who visit households, give vaccines, check pregnant women, screen for illnesses and raise alarm early when disease breaks out. For many rural families, they are the closest thing to a clinic.
Nigeria's own gap
Salako said Nigeria has about 83,000 community health workers. The Nation and The Sun, citing the minister, put the figure at 93,000, serving a population of more than 240 million. The sources gave different numbers for the continent's workforce too: Punch and The Sun reported about 1.36 million as of May 2026, while The Nation said about 1.06 million.
Across Africa, only 68 per cent of African Union member states formally count community health workers as part of their health workforce, the minister said. Only about half pay them from government budgets, and about 85 per cent of countries depend on donors for at least half of the funding.
"A workforce that is not recognised, paid, or planned for is a workforce that cannot be retained," Salako said, according to The Nation. He was represented at the forum by Dr John Ovayoru, Director of Health Planning, Research and Statistics.
The government says it is expanding primary healthcare under the Health Sector Renewal Investment Initiative and the Renewed Hope Agenda, with plans for a national policy, a workers' registry and more domestic funding, including through the Basic Health Care Provision Fund.
Pay delays push workers away
Amref Health Africa, working with the Mastercard Foundation, spoke to about 155 community health workers and young people in Kenya, Ethiopia, Tanzania, Malawi and Burkina Faso. Its programme director, Mieko Makai, said late salaries were the most common reason workers in four of the five countries thought about quitting. In Malawi, some health surveillance assistants waited up to three months for pay.
"Recruiting two million health workers is a question of numbers. Keeping them is a question of whether this is a job on which a young person can build a life," Makai said.
Prof Aliko Baba Ahmed, representing the Africa CDC, warned that donor funding for health has fallen sharply since 2021 and urged governments to create dedicated budget lines and put community health workers on public payrolls. UNICEF's Helga Fogstad said the workers should be the first point of contact in healthcare, not the last, and announced a continental scorecard to track countries' progress.
The forum is expected to end on Friday with an Abuja communiqué and roadmap setting out costed plans and financing commitments.
