2016 Annual Report

A Health Worker For Everyone, Everywhere, Every Day
continue to the digital report
Our mission is to save lives in the world's most remote communities.

Our year in review

Dear Friends,

During my last trip to Liberia - with a stethoscope draped around my neck - I had the privilege of caring for patients alongside Last Mile Health’s community health professionals in some of the most remote communities of Liberia. Together with my colleagues, I hiked, motor-biked, and paddled canoes to bring lifesaving medical care directly to patients living far beyond the reach of the health system.

At Last Mile Health, our vision is a health worker for everyone, everywhere, every day. It is a vision that will not be easily realized, but it is one that we must pursue.

Together, we’ve proven it’s possible to close the gap in access to care for those living in the world's most remote communities. With your partnership, and in collaboration with the Government of Liberia, we are now supporting more than 300 community health professionals in nearly 300 remote rural communities who extend primary care to more than 50,000 people. This year alone, Last Mile Health’s community health professionals conducted over 42,000 patient visits and treated more than 33,000 sick children with malaria, pneumonia, and diarrhea. In our pilot site, clinic-based maternal deliveries rose from baseline of 56 percent in 2012 to 96 percent in 2016.

Now we have a chance to change history and come another step closer to realizing our vision. With the support of Last Mile Health and other partners, the Government of Liberia is launching a groundbreaking community health worker initiative - called the National Community Health Assistant Program - to deploy over 4,000 Community Health Assistants and clinical supervisors to extend care to the 1.2 million people who live in Liberia’s most remote communities.

This progress would not be possible without your partnership. Together, we can extend health care to people living in some of the most marginalized places on Earth.

Sincerely,

Raj Panjabi, MD, MPH
CEO of Last Mile Health

To our valued partners and friends:

When I first joined Last Mile Health’s Board of Directors in 2012, our team was just launching our pilot program in Konobo. In fact, I was drawn to the organization because this was a group willing to go to the most remote corners of Liberia, despite the widespread belief that it could not be done. Soon thereafter, I was able to visit Konobo, where I witnessed firsthand the power of commitment and partnership to overcome immense challenges to improve access to healthcare and save lives.

From our early work treating patients in Konobo District to the work that is now underway to support the Government of Liberia’s National Community Health Assistant Program, I’m humbled by the ever-increasing positive impact of Last Mile Health on the lives of those living in the most remote and vulnerable communities. In January 2016, I had the opportunity to visit Rivercess County for the first time with our Board of Directors. As we traveled via truck, canoe, and on foot to visit health workers and patients in Lower Yarnee District, we saw what accessing the “last mile” truly means and why we focus our efforts there. At the same time, we were reminded of the importance of how we do our work. When access to primary care is provided through a model that is deeply rooted in the community and combined with compassion, it is transformative.

Now, as the organization embarks on another year, we recognize the long journey we still have ahead. Though Last Mile Health has grown quickly, we still remain small in comparison to the scope of the problem we aim to address: the one billion people worldwide who never see a health worker due to distance. Your support will continue to play a critical role in supporting Last Mile Health as we design, demonstrate, scale, and advocate for patients living at the last mile.

This is a critical moment for our organization, as we address one of the biggest challenges facing the world. Thank you for joining us in this mission, and for amplifying the courage and hope that exist at the last mile.

Sincerely,

Katherine Collins, MTS
CEO of Honeybee Capital
Last Mile Health Board of Directors

what we do

We're building resilient health systems that bring lifesaving care to the last mile.

Design

We have designed a replicable model for delivering health care to the last mile.

demonstrate

We implement our model in some of the most remote communities in Liberia.

Scale

We partner with government to scale public sector community health programming.

Advocate

We advocate for the health and development needs of last mile communities.

DESIGN

We have designed a model for bringing lifesaving health care to the last mile through a network of professional community health workers and supervisors

Our health workforce approach

We are working together with government to transform community health systems through a health workforce approach that's tailored to serving the most remote communities.

RECRUIT

To ensure that we’re choosing the best candidates to serve as community health workers, we partner with local leadership to recruit talent from within the remote communities we serve.

281
We have recruited and support a total of 281 CHWs across two counties.
CHWs from the Zammie Town catchment area in Rivercess County gather for Child Health training in December 2015

TRAIN

Community health workers receive four separate trainings covering infectious disease surveillance; reproductive, maternal, and neonatal health care; management of malaria, diarrhea, and acute respiratory infection in children under five; and additional services including first aid and community education on HIV/AIDS and tuberculosis. After completing each course, trainees are given time to develop their new skills before advancing to the next stage of training.

CHWs receive hands-on training on use of the rapid diagnostic test (RDT) for malaria at Child Health Training in Rivercess County in December 2015
"I never knew about malaria or about diarrhea before the training... Becoming a CHW made me to know what I never knew."
CHW Abraham Flanjay, Rivercess County

Equip

We strengthen supply chain, communication, and transportation systems to ensure that CHWs always have the drugs, tools, and forms that they need to provide lifesaving care.

1,071
Total number of supply restock visits recorded via Last Mile Health's mobile health (mHealth) platform
A CHW in Konobo District takes inventory of his medical supplies

Manage

Clinical supervisors provide CHWs with one-on-one mentorship to improve the quality of care they provide, and to ensure that they are accurately diagnosing and treating their patients.

Clinical Supervisor Momodu Kromah (right) conducts a supervision visit with CHW Ubo George (left) in Konobo District
3,401
The number of supervision visits that our CHW supervisors conducted from February through June 2016.

Pay

All of our CHWs receive monthly pay in recognition of the substantial time and energy they commit to providing care to their patients and honing their skills as professionals.

"Taking health to somebody is taking life to them."
Peer Supervisor Augustus Madehdou, Rivercess County
CHW Mary Yuolo demonstrates blood pressure monitoring in her community in Konobo District

DEMONSTRATE

Together with our government partners we have deployed hundreds of community health professionals who are bringing lifesaving care to Liberia's last mile

Who we serve

The world’s most remote communities tend to be where mortality is highest, access to health care is most limited, and quality of care is the worst. We serve more than 50,000 people across hundreds of last mile communities in Liberia's Grand Gedeh and Rivercess Counties.
Rivercess County, Konobo District, and Gboe-Ploe district together cover more than 2.5 million acres

Our impact in 2016

From July 2015 through June 2016, our community health workers treated thousands of patients and performed monthly home visits to every household they serve.
Our community health workers treated a total of 21,728 cases of illness in children under five.
In 2016, our CHWs treated
11,885
cases of malaria
In 2016, our CHWs treated
3,846
cases of diarrhea
In 2016, our CHWs treated
5,997
cases of acute respiratory infection (ARI)
CHW James Togba (Rivercess County) performs a rapid diagnostic test (RDT) to test a young patient for malaria
CHW Musu Johnson (Rivercess County) takes a mid-upper arm circumference (MUAC) measurement to screen a patient for malnutrition
In 2016, our CHWs conducted
19,228
routine home visits
Each month, our CHWs visit every household they serve to provide health education, track vaccination coverage in young children, and refer expectant mothers for antenatal care services. Our CHWs also use these opportunities to screen young children for signs of malnutrition.

SCALE

This year, we partnered with the Liberia Ministry of Health and their partners to design and launch a nationwide program that will deploy professional community health workers to serve the more than one million Liberians who live far from care

A year of progress

It's been a transformative year for Last Mile Health as we've aimed to turn local evidence from our work in Konobo District into national policy. The following slides offer snapshots of the journey.
July 2015
In partnership with President Ellen Johnson Sirleaf and others, Last Mile Health contributed to a report published by the United Nations Health Envoy’s Office that makes a case for strengthening health systems via investment in community health workers.

Read it here.
CHW Cynthia Tarley poses with her young daughter outside of their home in Konobo District

A year of Growth

Training Supervisors pose for a photo after a day of practical training on motorbike maintenance
August 2015
Our first cohort of Training Officers (including eight veteran Last Mile Health staff) underwent extensive training to prepare for their roles as mentors to our CHW Supervisors. Training Officers play an essential role in equipping CHW supervisors with coaching and mentorship skills, as well as in providing essential on-the-job training to CHWs in the field.
September 2015
We were awarded the 2015 Clinton Global Citizen Award for Leadership in Humanitarian Response alongside 28 other organizations who worked to end the Ebola outbreak in West Africa.

In the midst of the epidemic, hospitals and clinics closed their doors and people across Liberia died of common illnesses for lack of basic care. Trained in infection prevention and control and equipped with the supplies they needed to "keep safe, keep serving", our CHWs continued to provide lifesaving care throughout the outbreak.
Chelsea Clinton, Vice Chair of the Clinton Foundation, presents the 2015 Clinton Global Citizen Award for Leadership in Humanitarian Response
Liberia's Vice President Joseph Boakai (center) meets with Last Mile Health CEO Raj Panjabi (left) and Last Mile Health Country Director Bakary Sidibe (right) during a reception hosted by Last Mile Health in Monrovia, Liberia
December 2015
Following months of collaboration between the Liberia Ministry of Health, Last Mile Health, and other partners, the Government of Liberia officially approved the country's historic National Community Health Services Policy and Strategic Plan.

These guiding documents establish the foundation for a National Community Health Assistant (CHA) Program, which aims to deploy a professional community health worker to serve every remote community in Liberia by the year 2021.
January 2016
Following the completion of their training in Child Health in December, 120 CHWs from Rivercess County began providing lifesaving health care to children under five across 132 remote communities.
CHWs from the Bodowhea catchment area in Rivercess County celebrate the completion of Child Health training
A mother and her young child pose for a photograph in Gboe District, Grand Gedeh County
February 2016
Our team supported the Ministry of Health and its partners to develop training curricula to guide Liberia's National CHA Program. The National CHA Program will incorporate lessons learned from Last Mile Health's work in Konobo District as well as national and international best practices.
March 2016
We achieved full coverage of every remote community in Rivercess County, proving that it's possible to scale a professional community health workforce to a highly dispersed population.
CHW James George walks toward the Cestos River, which lies adjacent to his community in Rivercess County. Now that James is trained to treat common childhood illnesses, his fellow community members no longer have to make the expensive and lengthy journey by canoe to reach the nearest health facility for basic, lifesaving pediatric care
Last Mile Health staff in Monrovia, Liberia gather to celebrate the TIME 100 recognition
April 2016
Our CEO, Dr. Raj Panjabi, was named one of TIME Magazine’s 100 Most Influential People of 2016.

In his dedication of the honor, Former US President Bill Clinton wrote: "To spend time with Raj Panjabi is to see up close what happens when someone with uncommon courage and compassion puts himself on the front lines of the world’s most complex challenges."

Read the full tribute here.
May 2016
We were awarded one of a select number of grants from the United States Agency for International Development (USAID) for Integrating Community Health Systems. This award will allow our team to continue supporting the Government of Liberia to design and launch the National CHA Program, as well as to share what we learn on a global stage.
Training Officer Nimley Shilue hikes to the community of Zeagbeh in Gboe District, Grand Gedeh County
A Last Mile Health vehicle carries supplies and staff to a field site in Rivercess County
Looking Ahead
We launched a new, three- year Strategic Plan to guide the future of Last Mile Health as we design, demonstrate, scale and advocate for community health programming that meets the unique needs of those living in the world’s most remote communities.

Check out the full strategic plan here.

Driving toward scale

We are supporting the Government of Liberia to scale the National Community Health Assistant Program, which will provide more than one million people with access to lifesaving care by 2021.

A year of PROGRESS

It's been a transformative year for Last Mile Health as we've aimed to turn local evidence from our work in Konobo District into national policy. The following slides offer snapshots of the journey.
July 2015
In partnership with President Ellen Johnson Sirleaf and others, Last Mile Health contributed to a report published by the United Nations Health Envoy’s Office that makes a case for strengthening health systems via investment in community health workers.

Read it here.
August 2015
Our first cohort of Training Officers (including eight veteran Last Mile Health staff) underwent extensive training to prepare for their roles as mentors to our CHW Supervisors. Training Officers play an essential role in equipping CHW supervisors with coaching and mentorship skills, as well as in providing essential on-the-job training to CHWs in the field.
September 2015
We were awarded the 2015 Clinton Global Citizen Award for Leadership in Humanitarian Response alongside 28 other organizations who worked to end the Ebola outbreak in West Africa.
December 2015
Following months of collaboration between the Liberia Ministry of Health, Last Mile Health, and other partners, the Government of Liberia officially approved the country's historic National Community Health Services Policy and Strategic Plan. These guiding documents establish the foundation for a National Community Health Assistant (CHA) Program, which aims to deploy a professional community health worker to serve every remote community in Liberia by 2021.
January 2016
Following the completion of their training in Child Health in December, 120 CHWs from Rivercess County began providing lifesaving health care to children under five across 132 remote communities.
February 2016
Our team supported the Ministry of Health and its partners to develop training curricula to guide Liberia's National CHA Program. The National CHA Program will incorporate lessons learned from Last Mile Health's work in Konobo District as well as national and international best practices.
March 2016
We achieved full coverage of every remote community in Rivercess County, proving that it's possible to scale a professional community health workforce to a highly dispersed population.
April 2016
Our CEO, Dr. Raj Panjabi, was named one of TIME Magazine’s 100 Most Influential People of 2016. In his dedication of the honor, Former US President Bill Clinton wrote: "To spend time with Raj Panjabi is to see up close what happens when someone with uncommon courage and compassion puts himself on the front lines of the world’s most complex challenges."

Read the full tribute here.
May 2016
We were awarded one of a select number of grants from the United States Agency for International Development (USAID) for Integrating Community Health Systems. This award will allow our team to continue supporting the Government of Liberia to design and launch the National CHA Program, as well as to share what we learn on a global stage.
Looking Ahead
We launched a new, three- year Strategic Plan to guide the future of Last Mile Health as we design, demonstrate, scale and advocate for community health programming that meets the unique needs of those living in the world’s most remote communities.

Read the full strategic plan here.

ADVOCATE

With your support, we're working to address the broader health and development needs of remote communities by crowding resources to the last mile.

Financial Summary

One year ago, we set out with your support to take advantage of a tremendous opportunity to scale our impact.

Equipped with evidence and best practices from the community health worker program we've run in Konobo District since 2012, we partnered with the Government of Liberia to design and launch a nationwide community health workforce initiative that will extend lifesaving care to more than one million Liberians.

Over the past year, we scaled the National Community Health Assistant Program to more than 36,000 people across Rivercess County, but that was only the beginning.
We could not have made it this far without the generous support of our partners, and we look forward to continuing to work together in the year to come.
We could not have made it this far without the generous support of our partners, and we look forward to continuing to work together in the year to come.
X (CLOSE)
Go back to the report.