Celebrating Last Mile Health's 2023 milestones
Last Mile Health, along with Living Goods, was selected as an Audacious Project in 2018. Since then Virgin Unite has supported it in its goal to bring healthcare to remote communities.
In partnership with ministries of health, Last Mile Health has deployed more than 13,000 professional community health workers to provide essential health services to 14.1 million people.
Through its work, Last Mile Health has learnt some important lessons, and shown that its approach works. It partners with ministries of health to ensure that community health workers are skilled, salaried, supplied, and supervised as part of a well-functioning community health system operating at national scale.
In the last year, Last Mile Health has reached some important milestones in each of these areas:
Skilled
Last Mile Health and Ethiopia’s Ministry of Health piloted new training for community health workers. The results were convincing: training that’s delivered online and in person is a benefit to learners, as well as budgets, compared to traditional face-to-face learning. In July 2023, the Ministry of Health formally adopted a blended learning approach for all 40,000 of its community workers in Ethiopia. This will mean better learning outcomes for community health workers and for the Ministry of Health, it means more effective and affordable training for the community health workforce.
Supplied
In 2023, Last Mile Health’s Grand Bassa Impact Evaluation demonstrated that community health workers are the leading provider of care for sick children in this remote Liberian county. Since 2016 when the National Community Health Programme was launched, more than 1.1 million treatments have been delivered to children by community health workers in Liberia.
“We have data that tangibly shows the power and potential of community health workers. If you give them the tools they need, they’re able to deliver. Where they’re less successful, it’s because they’re lacking in those key conditions they need to succeed – for example, without adequate medicines, they simply can’t provide care. We must continue to think systematically to solve supply chain challenges and other obstacles that continue to hamper progress in service coverage,” Divya Nail, chief technical officer at Last Mile Health said.
Salaried
Community health workers deserve to be paid as professionals, with fair compensations that arrives regularly and on time. Though all community health workers supported by Last Mile Health are paid, this is unfortunately not the norm worldwide – in Africa, for example, just 14% are salaried.
At the Clinton Global Initiative’s annual meeting in September 2023, Last Mile Health and Integrate Health announced a joint commitment to action to work with African ministries of health to strengthen and sustain gender-responsive community health worker programs in four countries, as well as to share lessons learned to accelerate similar efforts across the continent.
Supervised
In remote communities, challenges such as long journeys, lack of internet access and paper-based reporting can make medical supervision and coordination more difficult. This year, Last Mile Health supported the Liberian Ministry of Health to trial a new electronic community-based information system, enabling community health workers and their supervisors to coordinate care, collect data and make data-driven clinical decisions.
Now, 74% of community health workers in Liberia have received two or more supervision visits in the last four weeks.
Operating at scale
In March 2023, Liberia launched a new community health policy, which includes putting community health supervisors on the national payroll, improving training for community health workers, and rolling out a new digital information system– all key components in ensuring the community health programme can operate effectively at national scale.
“Universal health coverage isn’t possible without engaging remote communities,” Liberia Minister of Health Dr Wilhemina Jallah said.
Systems integration
Community health workers are always busy. With patients to look after and home visits to conduct, it creates a lot of reporting that needs to be done – and this is often completed by hand. However, in Malawi’s Mchinji district, more than 250 community health workers completed training in the integrated Community Health Information System (iCHIS) this year. That brings the total number of community health workers across Malawi to complete iCHIS training to 1,740.
Last Mile Health developed the system in partnership with the Ministry of Health and the University of Malawi to support community health workers in capturing patient data, reporting it to district and national staff, and making treatment decisions.
Want to learn more about all that Last Mile Health achieved in 2023? Read the Mile By Mile impact report.