April 2019

{Marian W. Wentworth visits with health workers during a trip to Uganda in 2017. Photo credit: Warren Zelman}Marian W. Wentworth visits with health workers during a trip to Uganda in 2017. Photo credit: Warren Zelman

I began my career in the private sector almost always as the only woman in the room. Like many women of my generation, I experienced the kind of casual sexism that for too long was considered acceptable. But I also experienced firsthand more abusive forms of discrimination.  As I moved up in the organization, I began to see how sexism affected other women around me. I remember reviewing male and female candidates who were being assessed for readiness for promotion and noticing a distinct trend: The female candidates were assessed on their achievements; the male candidates on their potential. This situation worsened as candidates were actually selected for roles. Average achieving, “high potential” male candidates were being promoted over women who had tangible track records of accomplishments. While the trend was obvious, the solutions were not. We tried a series of different ways to shift this trend in our organization, but none produced quick results.  How we assess potential — and in whom — is but one example of the kind of systemic sexism that forces women to work harder to achieve professional success, and why some of us find it too much to fight.

{Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity} Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity

This article was originally published by Global Health Now.

Paid or volunteer?

Community health workers are on the frontlines in many countries—and vital to achieving universal health coverage. Yet the public health community has not reached a consensus on which model is the best.

Consensus is urgently needed, both at the global and country levels, to inform future policies and strategies for strengthening health systems and delivering on UHC.

Based on our experiences in rural Peru and Ethiopia, it’s not either-or. It’s both.

Full-time, paid CHWs form the backbone of family- and community-based services, but there aren’t enough to reach all families. We envision teams of government-paid, full-time CHWs providing comprehensive services to a given population, with a primary health center hub as the base of operations. Each CHW, in turn, would lead a team of part-time community health volunteers providing limited health education and referral services—such as maternal and newborn health, nutrition, hygiene, tuberculosis, malaria, and HIV/AIDS—to a small number of neighboring families.