Grace Bonwin is one of Liberia’s nearly 4,000 community health workers. In the midst of the pandemic, community health workers like Grace play a critical role educating their communities to prevent the spread of the virus and ensuring uninterrupted access to lifesaving primary healthcare services in spite of the public health emergency.
Grace provides essential, lifesaving care to her neighbors in a remote community in Rivercess County. She is supported by a clinical supervisor who visits regularly to ensure that she has the lifesaving drugs, supplies, and mentorship needed to provide quality care. Approximately 30% of Liberia’s 4.6 million people live farther than five kilometers from a health facility, requiring them to travel long distances, often at great cost and through dense rainforest to reach traditional points of care.
The National Community Health Assistant Program is a government-led initiative launched in 2016 to serve those living far from care. As the program approaches full scale, we are supporting the Liberia Ministry of Health to deepen the quality of service delivery in key programmatic areas, such as nutrition. Nationally, nearly one-third of children under the age of five suffer from chronic malnutrition and almost half a million are anaemic.
Grace has six children of her own, including her twin girls Mara and Clara. When her twins turned six months old, she started doing routine malnutrition screenings for them every month. One of the twins began to lose weight after the introduction of complementary foods. Grace immediately used her knowledge as a community health worker to provide her child with the healthiest diet possible. When she didn’t improve, Grace notified her nurse supervisor who counseled her to make a few changes to her breastfeeding routine. Within two weeks, her daughter had fully recovered.
To address widespread nutritional barriers in Rivercess County – a site of innovation for the national program – Last Mile Health, along with the county division of the Ministry of Health, conducted surveys in local food markets, focus group discussions, and a barrier analysis to better inform service delivery by community and frontline health workers. We are now working to support community health workers like Grace to augment healthcare service provision with community-based nutrition education, including the promotion of diversified protein sources and home-grown produce, as well as an emphasis on breastfeeding practices. Through these efforts, community and frontline health workers aim to improve nutritional outcomes, particularly for women and children, so that they are more likely to live healthy, productive lives.