Enhancing Community Health Through Mobility: Insights from AHAIC 2025

Today, Amref Health Africa, World Bicycle Relief (WBR), Johnson & Johnson (JNJ), Africa CDC, and the Ministry of Health Malawi took the global stage at AHAIC 2025. The 6th biennial conference, which kicked off today, brought together stakeholders, government ministries, donors, and partners to address the socio-ecological determinants of health. The parallel session, sponsored by World Bicycle Relief, Johnson and Johnson, ELMA Philanthropies, and Amref Health Africa, focused on a critical but often overlooked component of community health work: mobility.

Despite significant investments in professionalizing community health workers (CHWs), with Kenya setting an impressive precedent by training, equipping, digitizing, and remunerating CHWs, mobility remains a major challenge. Many CHWs still walk long distances across difficult terrain, which limits their efficiency and reach.

Moderated by Awa Dieng, Regional Manager at Amref Senegal, the session zeroed in on the role of mobility in sustainable development and community health work and its impact on CHWs’ welfare and productivity. As Awa noted, mobility poverty remains a challenge in the dialogue around CHW professionalization.

Anthony Gitau, Johnson and Johnson’s Director of Program Delivery and Impact for Africa and the Middle East, delivered the keynote address. He highlighted the conference theme, “Connected for Change,” emphasizing how CHWs connect communities to Primary Health Care (PHC) and preserve their future health outcomes. Reflecting on Kenya’s groundbreaking initiative to professionalize CHWs, Gitau stressed the importance of investing in community health to deliver universal health coverage (UHC). He underscored the urgency of using limited resources efficiently, given the global shortage of six million health workers, two million of whom are CHWs.

Collaboration amongst partners was also lauded to prevent fragmentation and inefficiency in managing the already limited resources. The African Frontline First (AFF) initiative, co-founded by the Johnson and Johnson and the Skoll Foundation, was highlighted. It raised $25 million, which was matched by the Global Fund to strengthen the community health workforce across different countries in Africa. Kenya’s advocacy efforts were also highlighted, with 67% of CHWs completing advocacy courses through the CHU4UHC platform.

Despite these strides, mobility remains a barrier. Gitau shared the example of Esther, a CHW from Kirinyaga County whom they encountered in October 2024. Esther walks long distances between households, a challenge that hampers her ability to deliver services efficiently. This encounter with Esther prompted the Foundation to relook at CHWs mobility.

“When someone has to cover 5 km between households, how can we make it easier for them?” Gitau posed.

Dr. Landry Dongmo Tsague, representing Africa CDC, commended CHWs’ dedication and emphasized the importance of investing in resilient health systems, particularly after the COVID-19 pandemic. He stressed the need for domestic resources to train, equip, digitize, and remunerate CHWs.

“COVID-19 reminded us of the importance of investing in resilient community health systems. If we’re serious about achieving UHC, we must invest in community health workers as the primary health workforce. We should not consider the CH as a second-class workforce but rather as a front-line workforce”– Dr Landry Dongmo

Precious Phiri from Malawi’s Public Health Division shared his country’s experience in addressing CHW mobility. Malawi’s community health acceleration roadmap prioritizes CHW motivation and transport, with partners like Amref Health Africa and Red Cross supporting these efforts. Phiri highlighted the government’s policy to purchase durable bicycles and the introduction of motorcycles to improve supply chain efficiency.

Maureen Kolenyo of World Bicycle Relief detailed the impact of bicycle solutions on CHW productivity, noting that WBR has distributed over 868,000 bicycles. In Zambia, CHWs equipped with bicycles reported a 63% increase in productivity, enabling them to reach more patients and improve maternal and child health outcomes. In April 2024, World Bicycle Relief, in collaboration with Amref Health Africa, distributed 100 bicycles in rural Kwale County, and the impact is already being felt. 

“Bicycles are affordable, efficient, have low impact on the environment and easy to use. We have insurmountable evidence to show that they transform health care delivery. A study in Zambia showed a 63% increase in service delivery where CHWs had bicycles. That’s the power of mobility.”– Maureen Kolenyo

Idah Mumba, a CHW from Zambia’s Malaria Elimination Program, shared her personal experience. Thanks to Amref’s support in providing a bicycle, Idah has enhanced her service delivery, visiting more households and improving community health.

“I serve 224 households, providing malaria tests, family planning, and maternal health support. The long distances were my biggest challenge. However, with a bicycle, I can now reach more families and deliver care on time.”– Idah Mumba

The Need for Political Goodwill and Strategic Partnerships

Achieving an optimized community health system requires more than resources. It demands political support and strategic collaboration. The panel session drew examples from the CHU4UHC platform and the Community Health Impact Coalition (CHIC), which have exemplified the approach of bringing partners together to align national policies with WHO’s community health worker guidelines and prioritize community health in budgeting and planning.

Anthony Gitau stressed the importance of engaging policymakers and not shying away from political conversations. “Politicians hold the keys to policy and budget decisions,” he noted. “We must work with them to ensure community health remains a priority.”

As the session concluded, participants called for greater investment in CHW mobility. The panelists urged stakeholders to prioritize CHW needs, advocate for resources, and ensure CHWs remain central to policy discussions. “In everything you do, put CHWs at the center and engage them. Listen to them to understand their challenges and increase the impact of our collective efforts,” Gitau concluded.

The AHAIC 2025 session underscored that mobility is not just a logistical issue but a crucial enabler of health equity and effective service delivery. As partners and governments continue their efforts to professionalize CHWs, addressing mobility poverty must remain a top priority.

As Africa advances towards UHC and PHC strengthening, mobility must be recognized not as an afterthought but as a fundamental enabler of efficient, professionalized CHWs.

Article first published on https://chu4uhc.org/enhancing-community-health-through-mobility-insights-from-ahaic-2025/