Community health workers: A model for achieving social justice in health in the Palestinian territories

An environment of conflict, political instability, and economic and geographical isolation of communities in the West Bank and Gaza, has challenged the Palestinian Ministry of Health (MoH) in its efforts to ensure provision of adequate health services to the Palestinian population. The Community Health Worker (CHW) model, introduced by popular health advocacy groups over three decades ago, is a strategic solution to this problem. Community health workers are key agents of change within their communities, providing access to healthcare and education in isolated and vulnerable areas. Fragmentation in the Palestinian health sector has resulted in unclear roles of community health workers in the MoH and NGOs, resulting in inconsistent access to and delivery of care in isolated and vulnerable areas. To address this problem, the 5 year, $86 million USAID Palestinian Health Sector Reform and Development Project (the Flagship Project) is supporting the MoH to develop a unified and standardized CHW program. Within its integrated, multi-sectoral approach to health sector reform and health service quality improvement, the Flagship Project has brought all health care stakeholders together to agree upon national standards for community health workers, including a comprehensive training and certification program. By engaging all health actors in this process, the project is helping to harmonize all Palestinian health actors behind a unified vision of the role of community health workers, driven by the MoH. The unified program can be replicated in other states with compromised access to health care as a result of conflict or political instability.