Opportunities for Empowering Young Women to Become Health Workers to Support HIV

Adolescent girls in school uniforms sitting at their desks.
Health workers play a critical role in achieving an AIDS-free generation as service providers, but also reduce adolescent girls’ and young women’s risk of HIV by educating and engaging them in the health sector.
Photo credit: Sarah Hoibak/VectorWorks

The achievements made in HIV and AIDS would not be possible without the tireless efforts of the health workers who support the delivery of HIV services. This week, we celebrate World Health Worker Week to commemorate the tireless efforts of health workers across the globe. We also take a moment to reflect on the opportunities for creating the next generation of female health worker heroes.

From clinicians in health facilities to health workers based in the community, health workers are often the first point of contact for persons seeking HIV care and treatment. Success is seen in the expansion and strengthening of the health workforce in countries constrained by health worker shortfalls. The U.S. Agency for International Development (USAID), through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), is a key contributor to this work, making significant investments in training more than 200,000 new health workers [PDF, 10.6MB] across PEPFAR countries. This has included training for doctors, nurses, pharmacists, social workers, community health workers, and beyond.

Despite these investments, gaps in health worker availability continue to impede HIV goals. Additionally, the evolving landscape of HIV service delivery has highlighted the critical importance of the community-based workforce as access to HIV services expands more into the community instead of a central medical facility. The community-based workforce is comprised of various roles across both health and social services (including community health workers, child and youth care workers and adherence supporters). This workforce is vital for identifying and linking children and adolescents to HIV services, leading to a further reduction of HIV infections among adolescent girls and young women (AGYW), a key group that accounts for 71 percent of new HIV infections in sub-Saharan Africa.

PEPFAR’s Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) Initiative is working to reach AGYW. The DREAMS Initiative uses multiple proven interventions to address one problem. Through DREAMS, USAID applies evidence-based approaches that go beyond the health sector, addressing the structural drivers that directly and indirectly increase girls’ HIV risk, including poverty, gender inequality, sexual violence and a lack of education, to help AGYW. Through DREAMS, linkages are created between retaining girls in secondary school and future employment. This is a clear opportunity to build on the DREAMS interventions in order to educate and engage young women in the health and social sector – filling the diverse needs and growing roles required for the HIV workforce.

Many PEPFAR countries are faced with a growing youth bulge and high rates of youth unemployment. This presents an opportunity to fill important roles in the health worker expansion needed to address the global deficit, recently estimated to be a gap of more than 18 million health workers [PDF, 505KB] by the World Health Organization. The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates that by 2030 only 26 percent of students [PDF, 258KB] will complete upper secondary school, potentially compromising the health worker education pipeline. Additionally, girls are severely underrepresented in secondary school completion, and health professional education (HPE) institutions’ recruitment practices may present additional barriers for female students. There are many HPE reforms that can be considered to support stronger recruitment and retention of female students. Additionally, the diverse roles required for the HIV workforce present a variety of growing health and social sector employment opportunities requiring varying levels of education and training. By providing greater opportunities for recruiting, training and employing young women to be part of the health workforce, a cyclical benefit is created. Young women’s vulnerability to HIV is reduced, while young women are developing into effective agents of change, who can further give back to their communities in supporting HIV service delivery, identifying and linking other AGYW into critical HIV prevention, care, and treatment services – all of which leads to a further reduction of HIV infections across the globe.

DREAMS is already prepping girls with skills for careers as health workers. In Uganda, USAID’s Strengthening Decentralization for Sustainability Program trainings has enrolled more than 8,800 AGYW who have been placed into 240 peer groups with trained peer educators. “I can now talk freely about HIV prevention and encourage my fellow peers still living in fear to come out and receive care and treatment services from the health units,” said Sharon, a peer educator, who supervises 50 fellow women.

By leveraging PEPFAR’s contributions to strengthening HPE institutions and training programs in sub-Saharan Africa, USAID can further strengthen and expand the pool of female applicants, prioritizing entry of high-risk young women from underserved areas into health workforce careers, ultimately supporting the development of a health workforce that is more gender equitable. “Addressing health worker challenges requires innovative cross sector solutions. Supporting AGYW to bridge employment gaps while fulfilling dreams of careers in health and social sectors can support development of the next generation of the HIV workforce,” said Diana Frymus, USAID Health Workforce Advisor. Increasing opportunities for women’s employment in the health workforce can foster significant impact on both women’s empowerment and economic participation, while also helping the global community gain significant ground in the fight against HIV and AIDS.

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