Dr. Kausar S. Khan has been awarded first place in the essay competition ‘A Vision of Tomorrow’s Community Health Workers’, part of the International Symposium on the Contribution of Community Health Workers to Attainment of the Sustainable Development Goals organized by Makerere University, Uganda, CHW Central, Nottingham Trent University, UK and World Vision in Kampala early this year.
Dr. Khan has been an active contributor to several discussions on CHWs and their significance, as part of Health for All debate as well as the Health Information for All global health network. Her essay on Community Health Workers: A Case of Reciprocal Empowerment, was selected by a reviewing committee from World Vision and Nottingham Trent University and read at the closing plenary at the International Symposium.
The committee applauded her for the “very holistic and visionary manner in which it addressed the key issues of global health and offered a real vision of an empowered female CHW while reflecting the whole CHW body.”
A member of AKU’s Department of Community Health Sciences (CHS), Dr. Khan has been working closely with CHWs since the late 1980s. As part of CHS’ mandate, an Urban Health Programme was initiated in 1985 in different squatter settlements in Karachi, with Primary Health Care centres catering to between 5,000 to 35,000 people. As part of the programme community members were trained as CHWs, who then formed an integral part of the department’s monitoring and evaluation system.
In her experience, Dr. Khan feels that “working with CHWs generates an interesting discussion around community participation amongst faculty and students, which is important for teaching-learning institutions. Once students interact with CHWs, their definition of community participation begins to differ from the existing literature.”
It also begins to redefine the term health. “Health is about physical, social and mental well-being and not just about the absence of disease,” she says, drawing attention to the discussion around the social determinants of health that began in the early 70s. Mortality and morbidity due to communicable diseases had begun to decline in the developing world; a decline before immunization and antibiotics became major players in the health-care market. Several studies looking into the period of decline saw that social determinants and the quality of living such as improved housing, availability of clean water, sanitation, education, employment in the region were improving.
It eventually led to the Alma-Ata Declaration of 1978 that focused the global debate on primary healthcare and the social determinants of health.
“However in our part of the developing world, there was a continued focus on a more clinical model of health care, on seeing health as treating a disease or an illness, or as eliminating harmful bacteria or providing health services,” says Dr. Khan.
If social determinants were to be addressed, the most viable strategy – that came out of various debates and discussions – was to train people from within the communities and villages to provide basic health care. “CHWs have since proven to be the backbone of primary health care especially for the developing countries. With their understanding of the communities and the social determinants of health at the grassroots level, CHWs are able to make a difference. They truly understand the wider set of forces and systems shaping daily life.”
In Pakistan, unfortunately, there are not too many institutions that develop and engage CHWs to improve the social determinants of health within their own communities. Dr. Kausar believes the “lack of initiative is due to a myopic interpretation of primary health care within the country and perhaps even the South Asian region”.
Dr. Khan hopes that in the near future AKU, or another institution, can organise a similar symposium, to provide a platform for people to share their learning on the “value of CHWs as change agents and liberators to national health systems”, while allowing for interdisciplinary collaboration and learning across sectors and initiatives.
“I feel that CHWs are here to stay as long as our public sector doesn’t take up the responsibility to look after the health of the people, especially the poor and the vulnerable,” says Dr. Khan.
Dr. Kausar S. Khan has been awarded first place in the essay competition ‘A Vision of Tomorrow’s Community Health Workers’, part of the International Symposium on the Contribution of Community Health Workers to Attainment of the Sustainable Development Goals organized by Makerere University, Uganda, CHW Central, Nottingham Trent University, UK and World Vision in Kampala early this year.
Dr. Khan has been an active contributor to several discussions on CHWs and their significance, as part of Health for All debate as well as the Health Information for All global health network. Her essay on Community Health Workers: A Case of Reciprocal Empowerment, was selected by a reviewing committee from World Vision and Nottingham Trent University and read at the closing plenary at the International Symposium.
The committee applauded her for the “very holistic and visionary manner in which it addressed the key issues of global health and offered a real vision of an empowered female CHW while reflecting the whole CHW body.”
A member of AKU’s Department of Community Health Sciences (CHS), Dr. Khan has been working closely with CHWs since the late 1980s. As part of CHS’ mandate, an Urban Health Programme was initiated in 1985 in different squatter settlements in Karachi, with Primary Health Care centres catering to between 5,000 to 35,000 people. As part of the programme community members were trained as CHWs, who then formed an integral part of the department’s monitoring and evaluation system.
In her experience, Dr. Khan feels that “working with CHWs generates an interesting discussion around community participation amongst faculty and students, which is important for teaching-learning institutions. Once students interact with CHWs, their definition of community participation begins to differ from the existing literature.”
It also begins to redefine the term health. “Health is about physical, social and mental well-being and not just about the absence of disease,” she says, drawing attention to the discussion around the social determinants of health that began in the early 70s. Mortality and morbidity due to communicable diseases had begun to decline in the developing world; a decline before immunization and antibiotics became major players in the health-care market. Several studies looking into the period of decline saw that social determinants and the quality of living such as improved housing, availability of clean water, sanitation, education, employment in the region were improving.
It eventually led to the Alma-Ata Declaration of 1978 that focused the global debate on primary healthcare and the social determinants of health.
“However in our part of the developing world, there was a continued focus on a more clinical model of health care, on seeing health as treating a disease or an illness, or as eliminating harmful bacteria or providing health services,” says Dr. Khan.
If social determinants were to be addressed, the most viable strategy – that came out of various debates and discussions – was to train people from within the communities and villages to provide basic health care. “CHWs have since proven to be the backbone of primary health care especially for the developing countries. With their understanding of the communities and the social determinants of health at the grassroots level, CHWs are able to make a difference. They truly understand the wider set of forces and systems shaping daily life.”
In Pakistan, unfortunately, there are not too many institutions that develop and engage CHWs to improve the social determinants of health within their own communities. Dr. Kausar believes the “lack of initiative is due to a myopic interpretation of primary health care within the country and perhaps even the South Asian region”.
Dr. Khan hopes that in the near future AKU, or another institution, can organise a similar symposium, to provide a platform for people to share their learning on the “value of CHWs as change agents and liberators to national health systems”, while allowing for interdisciplinary collaboration and learning across sectors and initiatives.
“I feel that CHWs are here to stay as long as our public sector doesn’t take up the responsibility to look after the health of the people, especially the poor and the vulnerable,” says Dr. Khan.