Save Lives in the World's Most Remote Villages

Daniel works as one of Liberia’s 3,500 formally employed community health workers. He provides essential, lifesaving care to his neighbors in a remote community in northern Rivercess, supported by Ghanwarkpa, a clinical supervisor who visits him regularly to ensure that he has the lifesaving drugs, supplies, and mentorship needed to provide quality care. Approximately 30% of Liberia’s 4.6 million people live farther than five kilometers from a health facility, requiring them to travel long distances, often at great cost and through dense rainforest to reach traditional points of care. Access has long been a challenge, contributing to significant disparities in service delivery and health outcomes across Liberia. Launched in 2016 – more than two years after the world’s deadliest Ebola outbreak began in a remote West African community not too dissimilar to Daniel’s – the National Community Health Assistant Program is a government-led initiative that serves those living in the country’s most remote areas.

Daniel is not the only healthcare professional in his household; his wife Hannah is a Trained Traditional Midwife serving the women and children of hers and other communities in the Gozohn Clinic catchment area. From her home, Hannah walks an hour to the main road where she takes a motorbike to work to assist Ghanwarkpa and other facility-based colleagues with antenatal check-ups for pregnant woman. Daniel and Hannah are members of their Community Health Committee, which meets twice a month to discuss solutions to self-identified health issues affecting the community. Together, Daniel, Hannah, and Ghanwarkpa work to ensure a complete continuum of care for children and families in their quiet corner of Rivercess County. Globally, their efforts are helping to inform the integration of quality community health interventions at scale, supporting the realization of universal health coverage and the drive towards ending preventable child and maternal deaths.

Hannah recently gave birth to a healthy baby boy named Andrew. Throughout her pregnancy, Hannah used her own experience to connect with mothers in the community and to encourage them to go to at least four antenatal care visits during their gestation period. Hannah herself had nearly twice the recommended number of check-ups, partly as a way to set an example in her community, and partly to help de-stigmatize doctor visits and recast them as a responsible approach to maternal health. Thanks to her work, her community has now instituted a fund for referring pregnant women to the Gozohn clinic – removing a significant barrier to maternal health care in the community. Because of women like Hannah, the number of women in Rivercess county who receive four or more antenatal care visits during their pregnancy has risen from 61% to 80% over the last four years. Together with her husband Daniel, Hannah is truly influencing the health of pregnant women and mothers in her area by ensuring that each one has a healthcare worker within reach when they need it most.

Having partnered with the Liberian Ministry of Health for more than 10 years, Last Mile Health is now expanding its work with governments around the world to design, scale, strengthen, and sustain teams of digitally-empowered community and frontline health workers who bring high-quality primary health care within reach of millions of rural people.

Links:

• 2019 Annual Report

Despite living in an age of unparalleled medical and technological innovations, one billion people still lack access to health care worldwide. To close this gap, Last Mile Health partners with governments to design, scale, strengthen, and sustain high-quality community health systems that extend care, save lives, and create jobs for underserved populations living in the most rural and remote communities. Founded in rural Liberia in 2007, the organization is now supporting the Ministry of Health to scale a National Community Health Worker Program that will deliver lifesaving services to every last child and family living beyond the reach of physical clinics and hospitals. This groundbreaking program was founded on the belief that a strong, resilient health system must reach every Liberian — no matter where they live.

Since the program’s launch in 2016, over 3,500 community and frontline health workers have been deployed to provide lifesaving care to every rural and remote Liberian. William - one of over 350 clinical supervisors deployed across Liberia – plays an essential role in the provision of quality health care at Liberia’s last mile. A trained midwife, William mentors and coaches community health workers to ensure they deliver the highest-quality of care, serving as a critical link between the community and the health center. He explains, “I’m proud of seeing myself supervising people, helping them to bring health to people. When they make mistakes, I correct them, and make sure that they bring quality services to people.”

1.2 million people in Liberia live more than five kilometers from a health center – many in remote communities in Liberia’s dense rainforest. For those who live hours - or even days - away from the nearest clinic, it used to be all too common for treatable conditions like malaria, a complicated childbirth, or untreated infection to be fatal. However, through the National Community Health Assistant Program, William sees how the health of people living in Liberia’s last mile communities has been transformed: “Before, there were a lot of cases that were killing children under five. But now – due to the Program – these cases have reduced. The workload from the clinic has also reduced, because most of the cases in the community have been addressed by the community health workers.” Through the program, over 790,000 sick child visits for the screening and treatment of malaria, diarrhea, pneumonia, and malnutrition have been carried out by this new workforce at the homes of the people they serve.

Liberia’s National Community Health Assistant Program has demonstrated that health care for all - no matter where people live - is possible. Clinical supervisors like William are playing a vital role in bringing quality primary health care within reach of everyone, everywhere. William’s drive comes from his vision of a world in which everyone can realize their right to health: “It has been my wish to serve humanity, and take health to places that health cannot reach, bringing health to people in need – that alone is my motivation”.