When the government of Liberia announced its plan to expand a program for community health workers (CHWs) from five counties to a country-wide initiative I felt the true value and impact of collective action. Too often in global health, we see project fails to sustain, but at VillageReach, we worked with the Liberian Ministry of Health and Social Welfare (MoHSW) from the beginning to design a solution that could have sustained impact at scale.
Between 2019 and 2023, VillageReach worked with MoHSW and Last Mile Health to connect CHWs, or community health assistants (CHAs) as they are known in Liberia, to the national supply chain. For 30 percent of the Liberian population, CHAs are the only touch point they have with the health care system. I worked closely with CHAs and partners to develop a kit commodity delivery system to ensure CHAs had the supplies needed to serve their communities.
In my experience, designing and implementing this program, this last-mile-oriented delivery system, was a game changer. When we first started the program none of the CHAs had consistent access to medicines and supplies, which led to frequent stock-outs that impeded their ability to provide a full range of primary health care services. For CHAs, consistent access to quality health products remains a challenge. Globally, CHWs are stocked out of essential medicines one-third of the time, and at a significantly higher rate than the health facilities they are associated with. Additionally, the lack of health supplies is a major hindrance to CHW’s productivity and motivation globally.
The kit commodity delivery system is a core element of VillageReach’s Supply Chain for Community Health Workers (SC4CHWs) solution, which was co-developed with MoHSW. This system works by packaging and distributing medicines and supplies in a predetermined kit based on individual CHA usage data and tailored to community health needs. This system ensures that life-saving medicines and supplies are equitably accessed by all approved and certified CHAs. Additionally, the regular delivery cadence ensures the availability of health products for continuity of care.
But these kits are so much more than just providing supplies, the kits also empower CHAs to be real change agents in building responsive primary health care system. The expansion of this program showcases the importance of ensuring CHWs everywhere are integrated into national health systems and are salaried, supported, supervised and supplied. Liberia has taken a major step in professionalizing CHWs and increasing the availability of health products when and where they are needed. The rest of Africa should take note.
Learn more about the impact of our work in Liberia.
The SC4CHW solution provides technical assistance to governments and communities in five main areas: human resources, data, advocacy, supply chain financing and transport. This solution is designed to adapt to country context and address specific challenges to the community health supply chain. It has been implemented in both Liberia and Kenya to date