West Africa is undergoing a profound transformation of its healthcare doctrine by accelerating the implementation of its community strategy. Driven by ECOWAS through the West African Health Organization (WAHO), this paradigm shift now places citizens and their immediate environment at the top of public priorities. This approach is moving beyond institutional frameworks to confront on-the-ground realities and the demands of proximity. The success of this reform now depends on the ability of States to turn these political commitments into measurable health outcomes for populations.
After eight years of preparation and its adoption in 2025, the Economic Community of West African States, through the West African Health Organization, is moving to implement its community health policy. The objective is to correct a model that has been too focused on curative care. Priority is now given to proximity, prevention, and local action. Implementation is based on five pillars: national adaptation, territorial governance, human resources, sustainable financing, and the community information system. At the heart of the system, community health workers ensure monitoring, alerting, and guidance, as close as possible to households.
The new community health policy, which does not break with the previous policy, allows primary healthcare to be at the heart of families, whether in homes or households. That is the only difference. It is an extension that will enable us to detect diseases or risks early and treat them.
Melchior Athanase Joël C. Aissi, Director General of WAHO
In Benin, years of accumulated experience serve as a reference. State funding to support community health has increased from 1 billion to 4.5 billion in 2026. Decentralization, and the involvement of prefects, and community relays: the model is showing results, particularly in prevention. The challenge now is to generalize this momentum across the region, in a context marked by significant disparities between countries and territories.
We are confident that this year, as we begin implementation and select pilot countries, we will gradually roll out this policy step by step. I believe results will not be immediately visible in the field. But to assess the impact, we may have to wait perhaps five years to see the added value for our populations.
Lionel SOGBOSSI, Primary healthcare professional at WAHO
The issue of remuneration for grassroots community health workers has come up. It remains a challenge in several West African countries. Often, when we talk about it, it feels like a dream because it requires commitment from our authorities and governments. So, upon learning about this policy, we are pleased that discussions are taking place on this point. This will also help guide a review of our strategies in implementing our program, which focuses on strengthening the community-based health system in Togo.
Émile Bobozi, Nurse and community health leader
At the heart of this reform remains a major challenge: securing stable and endogenous funding to ensure the sustainability of the model. The mobilization of ECOWAS parliamentarians is part of this effort. The reform aims to make healthcare truly accessible, effective, and visible where it is most needed at the heart of communities.
