Physical Health Liberia Project #5983

Save Lives in the World's Most Remote Villages

by Last Mile Health

Project Report | Apr 18, 2017
A Passion for Nursing at Liberia's Last Mile

By Freda Koomson | Partnerships & Development Associate

Annette, Gbediah Clinic, Rivercess County, Liberia

In a global context where illness is universal but access to care is still not, Liberia’s groundbreaking National Community Health Assistant (CHA) Program is on track to affect transformative and sustainable change for those living beyond the reach of the existing public sector health system. Informed by Last Mile Health’s (LMH) community programming in southeastern Liberia, this government owned program supports a network of locally-recruited, trained, managed, equipped, and paid CHAs who provide essential primary healthcare services to the country’s most remote and difficult to reach communities. Launched in July 2016, the program now supports 2,637 CHAs and 327 Community Health Services Supervisors (CHSS) who have been recruited and trained across 12 of Liberia’s 15 counties.

While CHAs are the cornerstone of the national program, they cannot operate in isolation, instead requiring leadership, oversight, and supportive supervision from across the health system from the community, to facility, county, and national levels. At the facility level, Officers in Charge (OIC) play an important role supervising CHSSs, with a direct impact on the quality of supervision in turn provided to CHAs, as well as the level of care available to remote populations through a strengthened continuum of care that includes robust referral pathways. A shining example of GlobalGiving’s vision of the “unleashed potential of people to make positive change happen”, Annette is the OIC at Gbediah Health Clinic, Rivercess County where she oversees primary healthcare services delivered at the clinic and in its surrounding catchment area.

An empowered, 24-year-old female health professional, Annette graduated with her nursing degree from the Stella Maris Polytechnic, Mother Patern School of Health Sciences in Monrovia. First deployed to Rivercess in 2016 as an Emergency Room Nurse at the county’s central hospital, she is well equipped for this role, understanding services that should be provided at the facility and community levels and recognizing more complex cases requiring escalation. Annette is stationed far from Monrovia where she went to school and spent most of her younger years. When asked why she decided to go into nursing, she is enthusiastic, explaining, “I have a passion for the field and it makes me happy to serve people. Knowing that when someone is dying you can assist, with the help of God, and can revive them gives me joy. I’m also happy to be able to contribute to our country and save lives.” Annette is eager to continue her education and asserts that “she has always wanted to excel in her academic and professional endeavors.”

In a world where one billion people lack access to a formal healthcare provider, passionate leaders like Annette remain critical to strengthening a continuum of care that recognizes CHAs as an integral component towards improved health outcomes for those living at the last mile. LMH remains grateful for support from the GlobalGiving community and looks forward to continued partnership towards the vision of a health worker for everyone, everywhere, every day.

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Jan 19, 2017
It Takes A Village

By Freda Koomson | Partnerships & Development Associate

CHA Abendego and Dr. Raj in Rivercess County.

Since the launch of Liberia’s National Community Health Assistant (NCHA) Program in July of 2016, progress has been ongoing to roll-out key components of the program. Last Mile Health (LMH) continues to support the Government of Liberia and the Ministry of Health to ensure that community health workers on the ground are trained, equipped, managed, and adequately supported to deliver healthcare to remote areas of the country.

Most recently, LMH, along with other implementing partners, met to discuss lessons learned from Community Health Services Supervisor (CHSS) trainings that have been completed in select counties. In Rivercess County, 19 CHSSs (who are responsible for supervising the Community Health Assistants or CHAs) recently completed their month-long training in the standardized national curriculum, joining the ranks of 277 CHSSs around the country who recently undertook this training.

The training included guided learning sessions on how best to supervise CHAs and ensure a high quality of care delivery in the following content areas: Reproductive, Maternal, Neonatal and Child Health; TB & HIV Outreach; Vaccination Outreach; Antenatal Outreach; and general Integrated Community Case Management.

CHAs across the country, like Abendego (pictured below with CEO and Founder of Last Mile Health, Dr. Raj Panjabi) of the Gorblee Community in Rivercess, have started their training as of January 16^th, 2017. Abendego works in a catchment area of about 100 households, all of which will soon be receiving care through Liberia’s NCHA Program. Last year, Abendego was the CHA on hand for early detection of malnutrition of an infant in his community. Thanks to Abendego, the child was referred to the main referral hospital in Rivercess County, St. Francis Hospital, for follow up care. Today, he is a healthy and energetic one year-old. Abendego’s work as a CHA has empowered him to think about continued professional advancement and perhaps returning to school in the near future.

The realization of LMH’s vision of “a health worker for everyone, everywhere, every day” requires buy-in from more than the government and its implementing partners. This vision is also fueled by the optimism and faith of the communities being served and the approximately 1.2 million Liberians living five kilometers out of reach of the nearest health facility. Expectant mothers who travel across rivers and through the rainforest to receive antenatal care do so because they trust the information and outreach services delivered by CHAs like Abendego. Thanks to generous support from the GlobalGiving community, key features of an inclusive and equitable health system are beginning to take root in Liberia. On behalf of all of the patients receiving care at the last mile, thank you for your continued partnership.

Links:

Last Mile Health's Website

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Oct 24, 2016
Building Healthy Communities Together

By Freda Koomson | Partnerships & Development Associate

In July 2016, the Liberia Ministry of Health (MOH) and its implementing partners launched the National Community Health Assistant (NCHA) Program. As a key implementing partner and technical advisor of the MOH, Last Mile Health’s (LMH) vision of “a health worker for everyone, everywhere, every day” is now being brought to scale at a national level.

Since the momentous launch of the NCHA Program, significant progress has been made to finalize many of its major components and ensure operational readiness at the central level for national roll-out. Over the past months LMH has supported the MOH and other implementing partners via the development of standardized curricula for the CHA and Community Health Services Supervisor (CHSS) cadres. Aligned with the newly revised National Community Health Services Policy and Strategic Plan, approved by the MOH and endorsed by the Cabinet of Her Excellency President Ellen Johnson Sirleaf in February 2016, these curriculum packages draw upon internationally recognized best practice, incorporating elements specific to the Liberian context in line with the experiences of and feedback from those most cognizant of the health care challenges facing the country’s most isolated areas.

Community Health Assistants (CHAs) like Yassa and Asamoah of the Sand Beach Gold Camp Community in Rivercess County are working in Rivercess County under the NCHA Program. They serve as shining examples to the thousands more who will join their ranks across the country delivering essential healthcare services. The young couple serve over 200 households in one of Liberia’s remote communities. Residents, so grateful for their healthcare assistance refer to them as their “doctors.”

The development of the NCHA Program, tailored to Liberia’s ‘last mile’ communities will do more than provide protection against future infectious disease crises. By creating over 4,100 jobs, alleviating the disease burden on marginalized communities, and encouraging health-seeking behavior, the program is expected to produce a “resilience dividend” that will yield far-reaching social and economic returns for the approximately 1.2 million Liberians living more than five kilometers from the nearest health facility.

We hope you'll share in our pride of what has been accomplished in Liberia, as well as in our optimism that Liberia's NCHA Program is advanced as a model for global community health system change.

Links:

Last Mile Health's Website

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