Last Mile Health

Last Mile Health (LMH) strives to create a world where a healthcare worker is within reach of everyone, everywhere. LMH supports countries in building teams of community and frontline health workers to deliver primary healthcare to the world’s most remote communities. LMH has trained over 14,500 paid, professional CHWs to extend primary healthcare to over 16.1 million people living at the last mile in Ethiopia, Liberia, Malawi, and Sierra Leone.

The Problem
Illness is universal; healthcare is not. Half of the world’s population lacks access to healthcare. This gap is particularly acute in remote communities where — owing to poor infrastructure, low population densities, and limited resources — mortality remains highest. Compounding this crisis is a massive health worker shortage, forecast to grow to 18 million by 2030. If these system failures are not addressed, an estimated 8.6 million people will continue to die annually from preventable causes because of where they live.

The Solution
LMH partners with governments to demonstrate that professionalized Community Health Workers (CHWs) — integrated into the public primary healthcare system — can reduce mortality and morbidity rates in remote communities and contribute to the global effort to achieve universal health coverage. LMH’s program theory posits that the community health workforce can effectively manage and deliver high-quality primary care when they are skilled, supplied, supervised, salaried, and integrated within government-led health systems. LMH believes that CHWs must also be supported with strong information systems, smart policies, and financing. This workforce ultimately increases access to healthcare and health equity, improves health outcomes in rural and remote communities, and serves as the first line of defense against epidemics.

LMH began their work in Liberia’s remote, last-mile communities and has grown to support four countries in Africa. Across Ethiopia, Liberia, Malawi, and Sierra Leone, LMH partners with governments to strengthen health systems, upskill workforces, and deliver community-based care and treatment for common childhood illnesses like malaria and diarrhea. This methodology supports their goal of expanding access to high-quality primary care within reach of people living in remote communities. LMH’s research and advocacy efforts promote the adoption of best practices and policies in community health globally – from how to design and build national programs to how to pay for them. Over the next decade, LMH hopes to catalyze a critical mass of government-led community health systems, delivering quality primary care for last-mile communities in low and middle-income countries.