Community Health Workers (CHWs) in Pakistan have reached a major milestone in their fight for recognition and better working conditions with the formation of the Pakistan Community Health Workers Federation (PCHWF), the first national trade union organizing this group of workers, at the end of November. The PCHWF unites five trade unions representing some 20,000 women polio workers, midwives, and other community health workers across the entire country.
Pakistan has approximately 125,000 CHWs, a workforce stemming from a program launched in 1994 to provide primary healthcare, particularly in rural areas. Despite their critical role in delivering care, women CHWs remain underappreciated and face precarious conditions. Organizations like Public Services International (PSI) and local unions have long advocated for better treatment, including securing minimum wages for these workers. Yet many still face delayed salaries and harassment, including physical attacks.
Read more: Community health workers in South Asia forge joint struggle for rights and recognition
A recent outburst of the violence was noted in September this year, when polio workers in Pakistan faced sexual assaults, beatings, and even murder. At the time, polio worker Kinza Malik told PSI that CHWs remain largely unrecognized, earning just 8,000 rupees (25 EUR) for five days of work during vaccination campaigns, despite being exposed to similar risks.
Even those CHWs whose status was formally recognized in 2012 continue to experience prejudice and neglect. “We educate and vaccinate the community, but we are often ignored and neglected,” said PCHWF Chairperson Rifasiayt Bibi. “With PCHWF as our united voice, we will fight for recognition, respect, and fair treatment.”
At the inauguration of the new federation, CHW representatives also committed to defending public health services, among other things. “Our federation will not allow the government to outsource health facilities. Together we will protect public health services,” pledged PCHWF President Halima Leghari.
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