Workshop: Strengthening CHW policies through a gender responsive tool

Gender inequalities exist CHWs at all levels from recruitment( who is recruited, how do they apply, how are they selected), to training (who has autonomy, time and resources to attend training), to roles and responsibilities (who is expected to deliver certain services, and who is likely to face harassment or violence), to remuneration (who gets paid and who doesn’t), as well as career progression - Johanna Riha, Research Lead, Gender Equality & Intersectionality, UNU-IIGH

CHW programmes in South Asia have been developed without sufficient gender and power analysis, and without incorporating inputs from female frontline workers – Susan Albone, Consultant, UNICEF ROSA

Background  

The United Nations University - International Institute for Global Health (UNU-IIGH) co-organized a virtual workshop with UNICEF Regional Office for South Asia (UNICEF ROSA) on 13th November 2025 during the 4th International CHW Summit. The workshop brought together researchers, policymakers, and CHWs to (1) discuss and deliberate on preliminary findings from ongoing research by the UNICEF ROSA that aims to analyse gender-sensitive policies and practices related to CHWs across South Asia ; (2) introduce the Gender-Responsive Policy Analysis Tool, developed by UNU-IIGH and UNICEF ROSA, and engage participants in a collaborative discussion about its relevance and the feasibility of implementing it in different contexts. The tool was developed with an intent to identify gaps and opportunities in CHW policies to address gender inequalities across the following six human resources for health (HRH) domains - recruitment; training; deployment, roles and responsibilities; remuneration; supervision/monitoring; and career progression.

Common Challenges and Systemic Barriers identified

All participants noted that CHW policies and programmes across the region share similar challenges. Existing frameworks focus on service delivery rather than on the conditions and realities of the workers themselves, resulting in gender-blind policies that fail to address safety, mobility constraints, or unpaid workloads. Most CHWs still work without contracts, benefits, or social protection, leaving them outside “decent work” norms. Supervision systems are often weak and inconsistent, limiting support for CHWs who already hold low status in health hierarchies. Intersectional factors such as caste, class, ethnicity, and geographic location further shape who becomes a CHW and how they are treated. These gaps, combined with limited CHW participation in policymaking, underscore the need for a stronger gender and power lens across the policy cycle.

Existing tools and what needs to happen next

Addressing gendered barriers in the community health workforce demands co-ordinated reforms at multiple levels, including policies, programmes, and communities. Countries need to apply gender and power lens when designing or revising CHW policies so that challenges around safety, mobility, workloads, and social norms are recognised early. Strengthening supportive supervision is the key, including training managers on bias, respectful oversight, and gender-responsive management. Policies must also ensure fair remuneration, social protection, clear reporting channels, formalised CHW roles, transparent salary and incentive structures, gender-responsive budgeting, and safer working conditions with clear Gender-based violence (GBV) pathways. Community engagement is essential to shift restrictive norms and build trust.  

Intersectional approaches should guide reforms, supported by integrating CHWs into workforce accounts and expanding leadership pathways for women. Tools such as the UNU-IIGH Gender-Responsive Policy Analysis Tool offer a simple, structured way to identify priority gaps, design realistic solutions, avoid unintended consequences, and strengthen fair, safe, and effective CHW policies.

Conclusion

Discussion at the workshop reiterated that gender inequality remains one of the most persistent challenges facing CHW policies and programmes in South Asia. Achieving progress will require bold policy shifts, stronger support structures, and meaningful inclusion of CHWs and communities in decisions that shape their work. The UNU-IIGH policy analysis tool offers a practical way for governments, CHW networks, unions, and UN partners to re-examine policies, set country-specific priorities to build safer, fairer, and more resilient CHW systems. Moving forward, collaboration across governments, unions, UN agencies, civil society, and CHWs themselves will be essential to ensure that gender equity is not only acknowledged but fully embedded in CHW governance and practice.