Updated Dec 19, 2018
Last Mile Health partners with government to demonstrate, design, scale, and advocate for national networks of professional community health workers who strengthen health systems and transform health outcomes at the last mile.http://lastmilehealth.org/
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LMH is working to build the capacity of the Liberian Ministry of Health to institutionalize the National Community Health Assistant Program, which will deploy 4,000 CHWs by the year 2021 to serve a population of 1.2 million.
As many as one billion people worldwide currently lack access to health care, many because they live too far from a health facility. Recent advances toward health equity have, by and large, failed to reach remote areas where mortality remains the highest, access to quality health care the most limited, and progress takes the longest to reach. These communities have historically been deemed as too difficult to serve and left without access to basic, lifesaving care.
Last Mile Health (LMH) saves lives in the world’s most remote communities by partnering with government to demonstrate, design, scale, and advocate for national networks of professional community health workers. Recruited from within their home communities, these workers strengthen health systems and transform health outcomes at the last mile by delivering an integrated package of lifesaving healthcare services directly to their neighbors’ doorsteps.
Since the launch of the National CHA Program two years ago, over 3,000 CHAs and 350 clinical supervisors have been trained to deliver a comprehensive package of primary healthcare services to over 700,000 people across 14 of Liberia’s 15 counties. To achieve just, efficient, and equitable healthcare delivery through this program, LMH remains focused on building government ownership and accountability via quality monitoring and supervision, while also supporting efforts to capture key learning to inform future program and policy design in Liberia and beyond.
In Grand Gedeh, Rivercess, and Grand Bassa, where LMH supports CHA deployment alongside County Health Teams, more than 570 CHAs and 55 clinical supervisors are now serving more than 192,000 people living in remote communities and near-facility catchment areas. In Grand Bassa, where LMH launched in August 2017, training is now underway for 101 CHAs who will be the first of a 260-member cadre to be deployed across four districts by April 2019.
Despite increasing recognition that frontline delivery of primary healthcare services can be an efficient and effective means of strengthening health systems and improving health outcomes, Liberia is one of only a few governments to have contributed sufficient investment, management, and monitoring to advance this type of initiative. Within this context, LMH's experience bringing the National CHA Program to reality provides vital insights regarding successful advocacy approaches, persistent gaps still to be addressed, and key elements that undermine ongoing efforts to ensure sustainable integrated primary healthcare in remote communities.