Despite medical and technological advances, half of the world’s population lacks access to essential health services, and over 8.9 million preventable deaths occur every year. In Last Mile Health’s target countries, including Liberia and Sierra Leone, maternal and child mortality ratios are among the highest in the world. Skilled health professional density is far below the WHO-recommended 23 per 10,000 population in these countries, and most health workers are concentrated in cities and large towns. Health services delivered only via doctors and nurses tend to leave those at the last mile behind, and disproportionately high rates of maternal and child mortality and morbidity exist in remote areas. The recent Ebola outbreaks and COVID-19 pandemic highlighted the need for stronger, more resilient health systems that reach even the world’s most remote communities, including disease surveillance systems that can identify the early warning signs of an outbreak before it has a chance to spread. In addition, to effectively advocate for, finance, and scale community-based primary health care that reaches all communities, policymakers and practitioners need increased access to evidence-based tools.

Research indicates that deploying community health workers who consistently and effectively provide just 30 lifesaving health services in the 73 countries with the highest burden of diseases would save as many as 3.6 million children annually – or 30 million lives by 2030 – reducing annual child mortality by almost half. The program is therefore strengthening resilient health systems by designing, demonstrating, scaling, and advocating for community health worker programming that is delivered at high quality. By doing so, the program works towards increased service utilization and decreased morbidity and mortality amongst those living in highly marginalized contexts.
Activities included:
● Design and roll-out of a digital training platform, the Community Health Academy, for health workers and health system leaders in partnership with the Ministry of Health in each program country. Using digital tools, health workers can
quickly access up-to-date information and clinical content needed to improve the quality of care. The Community Health Academy also provides courses on financing community health programs and national health system planning to
strengthen the capacity of current health system leaders and help train the next generation. Further resources include the COVID-19 Ethiopia app, the country’s first smartphone-based digital learning platform designed to increase
health workers’ ability to identify and treat patients, which was created in partnership with the Ethiopia Federal Ministry of Health and the Ethiopian Public Health Institute.
● Strengthening the National Community Health Program in Liberia with a focus on capacity building for data-driven health decision-making. This included development of a digitalization strategy for national monitoring systems, wherein
Community Based Information Systems play a central role in data collection, monitoring, and timely usage for community health.
● Evidence-based advocacy for integrated community health worker systems, by providing survey data on the impact of the National Community Health Program on child morbidity and mortality in Liberia