First-Hand: A Community Health Worker’s journey in slums and rural Nigeria

I started my career as a physiotherapist. I loved helping people, but I quickly realised that many patients could not follow through with the care I gave. Some could not afford transport to the clinic. Others did not understand the treatment. Many faced stigma that stopped them from seeking care at all.

That experience opened my eyes. I saw that real change needed to happen in the community, not just in hospitals. That is what inspired me to move into community health, and today I work as the Program Manager at the Slum and Rural Health Initiative (SRHIN). 

From the clinic to the community

For me, community health feels like an extension of family. When people are surrounded by familiar faces, they feel more comfortable and motivated to seek care. That is why community health workers (CHWs) are so important. They are trusted neighbours, friends, or teachers who people can turn to when they need health information or support.

At SRHI, we focus on three main areas: advocacy, research, and technology. We train and support young people to become CHWs, especially in slum and rural areas where health services are scarce. These young people talk to their peers about HIV prevention, maternal health, and disability inclusion. They also help connect people to clinics and make sure services are accessible.

No two days are ever the same. Some mornings, I am checking in with our team of Health Equity Champions across Nigeria. These are young Community Healthcare Volunteers who lead activities in their communities. The activities range from HIV education to supporting women during antenatal visits. On other days, I join them in the field. You may find me sitting with mothers at a health centre or talking with young people about HIV testing.

In Abuja, I have been working on the Include Project, which makes sure people with disabilities can access HIV services. We train carers, teachers, and disability advocates to share health information. They are also trained to encourage testing and treatment. By starting from within the community, people feel more confident to seek care.

Breaking barriers to care

In many slum and rural areas, people have very limited access to health services. Clinics can be hours away from someone's home . Treatment is  expensive, and stigma keeps people from going. For women, cultural barriers make it even harder. For example, some families expect men to decide if women can visit a clinic. Others believe that talking about sexual health is shameful or taboo. These cultural norms stop many women from seeking the care they need. For persons with disabilities, services are often not designed with their needs in mind.

Through our CHWs, we try to break these barriers. People are more likely to listen and take action when they share health messages. This is mainly because they are trusted members of the community. By working together with nurses and doctors, CHWs help bridge the gap between communities and the health system.

One of the most powerful experiences I have had was through the SimbiHealth Project in Northern Nigeria. We trained ten women to become leaders on various services. The services included family planning, maternal health, and HIV services.

One woman told us she had never used formal health services before - all her deliveries had been at home. She did not believe she had the power to change anything. But after joining the project, she became a leader in her community. She mobilised other women, and formed a group of over 1,000 members. She even advocated to local leaders for better services.

As a result, more women in her community are now attending health centres. More women are now accessing family planning, and getting tested for HIV. For me, this shows the power of empowering one woman. The impact spreads to her family, her daughters, and her whole community.

Looking ahead with hope

One challenge I often face is getting approval to work in some communities. Sometimes it is simple. But other times it requires long discussions with traditional and religious leaders. Building trust takes time.

We overcome this by letting community members themselves lead the way. When CHWs introduce new projects, people are more open to listening and engaging.

I would like to see CHWs fully recognised as part of the health system. Too often, they are seen as temporary volunteers. But in reality, they are the only health workers many people ever meet. They deserve proper pay, training, and resources to do their jobs well and safely.

I also believe young people have a big role to play. They can strengthen community health and help shape the future of healthcare in Africa. Young people can do this by volunteering their skills or pushing for inclusive policies. They can even create simple technology tools.

If I could leave you with one message, it is this: community health workers are not “helpers on the side.” They are professionals saving lives every day in places where the health system does not reach. Supporting them is one of the best ways we can build a healthier and more equitable Africa.