Last Mile Health: Caring for Even the Remotest Communities

In 2003, Liberia emerged from more than a decade of civil war. After so many years of violence, the country’s health infrastructure was devastated. Only 50 doctors remained to treat a population of more than 4 million people. If you got sick in the city, you stood a chance. But if you fell ill in remote villages—many of which are days away from the nearest clinic—you could die anonymously of a treatable condition like pneumonia, diarrhea, malaria or malnutrition. 

This problem goes well beyond post-civil war Liberia. Today, one billion people around the world, including 400 million rural Africans, go their entire lives without seeing a health worker. Although half of the world’s population lives in rural areas, only 23% of health workers globally are deployed there, leaving a major gap in healthcare access for last mile communities. This makes it nearly impossible for them to receive life-saving care.

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Luckily, there’s Last Mile Health, an innovative nonprofit that is expanding access to health services to these often overlooked communities.  

What’s the story?

In 2007, a group of Liberian civil war survivors and American health workers came together to address the rampant health issues that were affecting their country. Raj Panjabi, Alphonso Mouwon, Weafus Quitoe, Marcus Kudee, Peter Luckow, and Amisha Raja co-founded an organization committed to seeking truth and justice for Liberia’s rural poor. They called themselves Tiyatien Health, which means “justice in health” in a local Liberian language. With only $6,000 in seed money, Tiyatien Health began Liberia’s first rural public HIV program treating patients in a gutted closet in a war-torn building in Zwedru.

Almost immediately, the founders and their growing team realized the greatest needs were in Liberia’s last mile, in villages that were more than five kilometers away from the nearest health clinic, where people couldn’t access healthcare due to distance and poverty. They wanted to find a way to bring healthcare to these remote communities.

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Thus, in 2013, with a refined focus and ambitious vision for the future, Tiyatien Health became Last Mile Health.

Last Mile Health’s Novel Solution

The founders set out to create a new workforce of community health professionals by recruiting, training, equipping, managing and employing community members to provide health care in their own villages, and then link them to the local primary health system.

Last Mile Health takes health services out of the facility and onto the villagers’ doorstep, where it can have the most impact. Through the organization’s model, frontline health workers tackle 75% of the burden of disease right in the village, which effectively overcomes the access gap and saves lives.

Last Mile Health serves as a dedicated partner to the Liberia Ministry of Health and is more committed than ever to bridging the gap between clinics and remote villages, bringing primary health services to people living in the last mile throughout the country.

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How it works
  1. Community Health Workers (CHWs) are recruited directly from the communities they serve based on their talent, commitment and ability.
  2. CHWs complete a rigorous training program over the course of 12 months. The program includes mentorship from clinicians like nurses, midwives and physician assistants, and training in four modules: community and health surveillance, child health, maternal and neonatal health, and adult health.
  3. CHWs are equipped with life-saving diagnostic and curative medical supplies to ensure they are reliably stocked with the tools they need to provide care directly to the community.
  4. CHWs are mentored by supervisors, who conduct weekly clinical supervision visits to ensure patients are receiving the highest quality care.
  5. CHWs are paid for their work, like the true community health professionals they are. Not only do they make a living wage, but they are also eligible for performance-based incentives.
What’s the impact? 
When Last Mile Health started working in Konobo at the invitation of the Government of Liberia in 2012, the average age was 28.6 years. Today, the organization has recruited, trained, and deployed three cohorts of professionalized CHWs to provide 100% coverage in Konobo, building a stronger health system that supports the government’s primary care facilities.
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Investment in CHWs in sub-Saharan Africa can yield an economic return of $10 for every $1 invested by providing jobs, thwarting epidemics, and keeping people healthy. (U.N. Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria, 2015)

Since 2014, the number of Last Mile Health CHWs has increased five-fold and the amount of people served jumped from 10,000 to almost 60,000.

Get involved

You can support Last Mile Health’s critical work in remote rural communities by making a donation on their website. Alternatively, you can create a charitable wedding registry to help train Community Health Workers working in last mile villages.

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