Systems Change

To create lasting change, we must identify the root causes holding patients back from accessing care and transform the structures, policies, and power dynamics to enable universal access.

When community health workers are skilled, salaried, supplied and supervised, they can effectively deliver essential primary care for patients, especially children and women of reproductive age. But too often, community health systems are not designed or managed in a way that can deliver these results.

At Last Mile Health, we want to solve long-term problems at scale, so we have coupled our direct service work in primary care delivery with systems change efforts that address the root causes of inequitable healthcare access and shift the underlying structures, policies, and power dynamics that hold the current, unjust status quo in place. We work to transform systems and ensure they have breadth (focused on scale), depth (focused on quality), and durability (focused on resilience).

Through systems change efforts like Liberia’s National Community Health Program and Africa Frontline First, we contribute to more just and effective community health systems, built on good governance, evidence-based policies, long-term financing, data systems, and processes to assess performance and drive improvements to delivery. Our aim is to catalyze a critical mass of exemplary community health systems in which governments, non-governmental organizations, and big aid institutions, like the World Bank, USAID, and the Global Fund, work together to coordinate their financing and to fill gaps in the system.

people sitting a a table with paper and pens

Our Approach

Over the last decade, Last Mile Health has been at the forefront of efforts to change mindsets, policies, and international funding flows, to enable professionalized community health workers to deliver high quality care to patients at the last mile.

These efforts include:

  • Partnering directly with governments to design, scale, strengthen, and sustain exemplary community health programs. Our work targets critical levers to support high-performing health systems, including policy, financing, workforce training, and digital capacity.
man speaking to a group of people
man speaking to a group of people
  • Advocating for stronger community health funding, mobilizing resources and aligning funders toward a common goal. We work to influence the availability, durability, and effective deployment of funding for community health through regional advocacy and national accompaniment.
  • Generating insights on driving government adoption of systems change at national scale, to provide actionable guidance for systems change. Through research, thought leadership, and direct partnerships, we share our learnings as implementers to inform global norms and policies.

This work generates evidence, shifts practice, attracts financing, and builds political will to catalyze government-led community health systems capable of delivering quality primary care for rural and remote communities.

Resources

Read More on Last Mile Health’s Blog

Blog Post

Removing the financing barrier to strong community health systems: Africa Frontline First

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Blog Post

Stronger systems, better care: Training Malawi’s community health workers in iCHIS

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Blog Post

Last Mile Health and Ministry of Health pilot electronic Community-Based Information System

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Blog Post

Strong financing for strong community health: Last Mile Health serves as lead implementer of the Global Fund’s Project BIRCH

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