When Adenike Akinola first became a Community Health Worker (CHW) in Lagos State, she thought her biggest task would be teaching women about maternal health and childhood immunization. She soon discovered that the reality was much heavier.
On some days, Adenike would walk several kilometers under the sun to reach remote villages, carrying nothing but a notebook and a few health leaflets. She often faced suspicion, some families accused her of “bringing government medicine to control women.” Yet, when children fell ill or a pregnant woman was in distress, those same families turned to her for help.
Her story is not unique. Across Nigeria, CHWs are the backbone of grassroots healthcare, bridging the gap between communities and formal health systems. But like Adenike, they face daunting challenges that make their work both exhausting and underappreciated.
Life Saver Challenges Includes;
Workload & Resources:
CHWs like Adenike juggle responsibilities for hundreds of people. From immunizations and antenatal care to malaria awareness and nutrition counseling, the demands never end. With limited pay, no transport allowance, and scarce medical supplies, they are often expected to do so much with so little.
Support & Integration:
Adenike admits that some days she feels alone in her work. “We don’t always get supervision. If you face a difficult case, you just do your best,” she said. This lack of structured support limits professional growth and leaves CHWs disconnected from the larger health system.
Community & Social Barriers:
Beyond the medical tasks, there’s the human challenge of building trust. Some families refuse her advice, citing cultural or religious reasons. Others accuse her of interfering in private matters, especially when she counsels women about family planning.
Training & Knowledge Gaps:
Adenike has been trained in basic maternal and child health, but when she encounters mental health concerns or complicated pregnancies, she feels unprepared. Like many CHWs, the training she receives is not enough for the complex realities she faces.
Gendered Barriers:
As a woman, Adenike finds it difficult to advise men directly, particularly in conservative households. Male CHWs, on the other hand, often cannot speak freely to women about reproductive health. These cultural barriers limit how well CHWs can serve their communities.
Systemic Issues:
Inconsistent policies and the lack of recognition for CHWs’ roles make matters worse. Many feel they are seen as volunteers rather than professionals, despite the fact that their work saves lives every day.
The Path Toward Solutions:
Adenike’s story also highlights the hope that lies in practical solutions:
Professional Development
Continuous training tailored to local health needs can build CHWs’ capacity and confidence.
• Improved Compensation & Working Conditions: Fair pay, transport allowances, and adequate supplies can ease the burden and keep morale high.
• Stronger Supervision & Mentorship: Regular guidance and mentorship help CHWs handle complex cases and feel valued within the system.
• Enhanced Infrastructure & Technology: Simple tools, like mobile health apps, bicycles, or medical kits, could transform their reach and effectiveness.
• Community-Based Collaboration: Working with religious and traditional leaders can help break suspicion, ensuring health messages are accepted.
• Clear Role Definition & Integration: Official recognition and integration into the health system will affirm CHWs as indispensable health professionals.
Final Thoughts
As Adenike reflects on her work, she says: “Even when it’s hard, I remind myself that if I don’t show up, a child might not get vaccinated, or a mother might not get the care she needs.”
Her words echo the resilience of countless CHWs across Nigeria. They are unsung heroes, overworked, underpaid, yet deeply committed. Supporting them is not just about fairness; it is about strengthening the very foundation of healthcare in our communities.
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