The 5th Global Symposium on Health Systems Research is being held in Liverpool UK from 8 to 12 October 2018. Members of the HST team attending the symposium will be sharing insights and learnings from the conference thought the week.

Mildred Shabangu, Operations Manager for Health Systems Trust's SA SURE Plus Project, attended a panel session on "making universal health coverage a reality by 2030" hosted by the ESRC DFID partnership (the Economic and Social Research Council and the UK's Department for International Development).
Evidence-based cases from Nigeria, Mozambique and Ethiopia were discussed during the session. All cases focused on investing in community health workers (CHWs) to support the achievement of universal health coverage by 2030. This calls for policy-makers to leverage existing initiatives rather than 'reinventing the wheel', and to involve all stakeholders in policy formulation.
Although there are a multitude of active CHWs in these countries, they are not supported in case-finding by their governments through resourcing with information systems or efficient referral mechanisms. This results in CHWs carrying the costs of engaging with and serving communities.
The presenters also shared successes achieved, notably collaboration between CHWs and the private sector to improve treatment uptake. The findings demonstrated that CHWs play an important role in mobilising their communities to engage in their healthcare issues.
Challenges noted included the uneven distribution of CHW capacity, a lack of salaries for CHWs, and poor supervision of CHWs. These challenges are also experienced in South Africa, where Outreach Team Leaders of CHWs lack proper supervision and inadequate human resources for health, as well as absenteeism and high staff turnover, place inordinate strain on the health system.