Gendered Realities From the UNU-IIGH Symposium on Workplace Violence and Safety for CHWs

We are scared because of the crime in our communities where we live. We are constantly scared because the cars that we use are hijacked, and we are held at gunpoint in these communities. – Nolufefe Rhasmeni, Khayelitsha

Background Info

The virtual panel discussion was organised by UNU-IIGH and Imarisha Consortium partners on 12 November 2025 during the 4th International CHW Summit. The session examined one of the most urgent yet overlooked challenges facing Community Health Workers (CHWs) - gendered workplace violence (WPV). CHWs across Africa and South Asia operate in insecure settings, including conflict-affected areas, high-crime communities, and places with limited state presence. As a largely female workforce, they face heightened risks of harassment, intimidation, and violence, often without adequate protection or reporting mechanisms. Speakers from Tanzania, South Africa, Burkina Faso, Ethiopia, and global networks shared evidence and lived experiences showing how gender, power, and vulnerability shape CHW safety and why violence against CHWs undermines equitable primary healthcare.

Common Challenges and Systemic Barriers identified

• Widespread and Normalised Violence - Violence against CHWs is common and often treated as routine. CHWs report verbal abuses, intimidation, robbery, and harassment during home visits, outreach, and movement through unsafe areas.

• Gendered Risks and Mobility Constraints - Women CHWs face heightened risks due to unsafe travel, gender norms restricting mobility, and fear of sexual harassment. These constraints shape where and when they can work.

• Informal Status and Lack of Protection - Many CHWs work without contracts, benefits, or legal recognition, leaving them without grievance channels, compensation, or psychosocial support when violence occurs.

• Weak or Absent Reporting Systems - Confidential reporting pathways are rare, and few mechanisms link cases to police, health, or social services. As a result, many CHWs navigate violence without institutional support.

What Needs to Happen Next to Strengthen CHW Safety and Protection

• Formal Recognition and Protective Policies - Countries must formally recognise CHWs and integrate safety measures into national policies including GBV reporting pathways, safer mobility arrangements, and clear supervisory roles.

• Supportive, Gender-Responsive Supervision - Supervisors should be trained in gender-sensitive management, respectful communication, and safe handling of violence cases to reduce daily risks and support CHWs’ wellbeing.

• Community Engagement and Norm Change - Reducing violence requires engaging community leaders, women’s groups, and local safety structures to shift harmful norms and build trust in CHWs as legitimate health providers.

• Integrated Multisectoral Protection Systems - Safer environments depend on collaboration across health, police, and social services, as well as investments in psychosocial support, peer networks, and secure reporting tools. Intersectional factors gender, class, age, geography, and conflict dynamics must shape all reforms.

Conclusion

The webinar showed that workplace violence is a widespread, deeply gendered challenge that CHWs face every day, yet it remains largely absent from policy discussions. For health systems to be equitable, governments and partners must prioritise the safety, dignity, and rights of CHWs who form the backbone of primary healthcare. Insights from Tanzania, South Africa, Burkina Faso and Ethiopia point to a clear path forward: stronger legal protections, supportive supervision, safer working environments, community engagement, and policies grounded in CHWs’ lived realities. Through evidence, tools, and convening power, UNU-IIGH and partners can help ensure CHW safety becomes central to quality care, gender equality, and resilient health systems.