In many rural areas of Africa, distance remains one of the greatest obstacles to healthcare access.
At the recently concluded Africa Health Agenda International Conference (AHAIC) 2025 in Kigali, Rwanda, mobility emerged as a critical yet often overlooked component of community health work.
A parallel session titled "Towards Professionalizing Community Health Workers: Mobility, The Missing Link" brought together key stakeholders, including Amref Health Africa, World Bicycle Relief (WBR), Johnson & Johnson (JNJ), Africa CDC, and the Ministry of Health Malawi, to discuss how transportation solutions can strengthen health systems across the continent.
Idah Mumba, a community health worker (CHW) from Zambia’s Malaria Elimination Program, shared her experience as a panelist during the session.
"I serve 224 households, providing malaria tests, family planning, and maternal health support. The long distances were my biggest challenge," she recounted.
For Idah, this challenge defined her daily routine. Each morning, she would set out early, walking miles under the scorching sun or through muddy paths to reach households in need.
With no reliable means of transport, she spent hours traveling between villages, limiting the number of families she could visit each day. However, her work transformed when she received a bicycle through Amref’s partnership with World Bicycle Relief. This simple yet profound tool expanded her capacity to serve.
With a bicycle, Idah could visit more households in less time, respond promptly to emergencies, and ensure consistent follow-ups with patients.
"With a bicycle, I can now reach more families and deliver care on time," she said, highlighting the immense impact of mobility on healthcare delivery.
Moderated by Awa Dieng, Regional Manager at Amref West Africa, the AHAIC session explored the pressing mobility challenges faced by CHWs. Despite significant investments in training, equipping, digitising, and remunerating CHWs, many still traverse long distances on foot, hindering their efficiency and reach. This mobility poverty remains a critical barrier to effective healthcare delivery.
Anthony Gitau, Johnson & Johnson’s Director of Program Delivery and Impact for Africa and the Middle East, delivered the keynote address. He emphasized the conference theme, "Connected for Change," underscoring how CHWs serve as vital links between communities and primary healthcare systems.
Gitau highlighted the importance of investing in community health to achieve Universal Health Coverage (UHC), especially given the global shortage of six million health workers, two million of whom are CHWs.
He also shared insights from the African Frontline First (AFF) initiative, co-founded by Johnson & Johnson and the Skoll Foundation, which raised $25 million to strengthen Africa’s community health workforce.
He recounted the story of Esther, a CHW from Kirinyaga County, Kenya, who walks long distances between households.
"When someone has to cover 5 km between households, how can we make it easier for them?" Gitau posed, emphasizing the need for sustainable mobility solutions.
Dr. Landry Dongmo Tsague of the Africa CDC echoed this sentiment, highlighting the dedication of CHWs and the necessity of investing in resilient health systems, particularly in the aftermath of the COVID-19 pandemic.
He stressed the need for domestic resources to train, equip, digitize, and remunerate CHWs, recognizing them as a frontline workforce essential to achieving UHC.
Malawi’s approach to addressing CHW mobility challenges was shared by Precious Phiri from the country's Public Health Division.
The Malawi Community Health Acceleration Roadmap prioritizes CHW motivation and transport, with support from partners like Amref Health Africa and the Red Cross.
Government policies now focus on purchasing durable bicycles and introducing motorcycles to improve supply chain efficiency.
Maureen Kolenyo, Regional Director for East Africa at World Bicycle Relief, detailed the impact of bicycles on CHW productivity.
She noted that World Bicycle Relief has distributed over 868,000 bicycles, significantly improving healthcare delivery.
In Zambia, CHWs equipped with bicycles reported a 63 per cent increase in productivity, enabling them to reach more patients and enhance maternal and child health outcomes.
“Bicycles are affordable, efficient, have a low impact on the environment, and are easy to use. We have insurmountable evidence to show that they transform healthcare delivery," said Kolenyo.
Since its founding in 2005, World Bicycle Relief has distributed more than 191,830 Buffalo Bicycles to health workers in 10 countries, accelerating the progress and magnifying the impact of critical healthcare programmes.
These bicycles ensure CHWs spend less time in transit and more time with patients—delivering vaccines, medicines, and family planning services, ensuring compliance with TB and HIV medication, and helping transport women in labor and critically ill patients via bicycle ambulances.
The session concluded with a strong consensus on the urgent need to address mobility challenges to enhance healthcare delivery.
Equipping CHWs with bicycles is a cost-effective and sustainable solution that empowers them to serve their communities more effectively.
As exemplified by Idah’s experience, mobility is not just a matter of convenience but a pivotal factor in achieving health equity and improving health outcomes across Africa.
By investing in mobility solutions like bicycles, health systems can bridge the gap between healthcare providers and communities, ensuring that no one is left behind in the pursuit of Universal Health Coverage.
