Last Mile Health saves lives in the world’s most remote communities. The organization aims to deliver high-quality primary health services to more than one million people in Liberia’s most remote communities by partnering with like-minded organizations and governments to deploy, sustain, and manage national networks of community health professionals.
Geographic Area of Impact: Liberia
Model: Leveraged Non-Profit
Number of Direct Beneficiaries: 50,000 (2016)
Number of Beneficiaries Through Government: 400,000 (2017)
Annual Budget: $10,000,000 (2016)
Percentage Earned Revenue: 3%
The Social Problem
Over one billion people worldwide lack access to healthcare because they live too far from a health facility. This problem is particularly acute in remote Liberia, where people living in communities furthest from the reach of the health system are least likely to have access to care and often must walk for hours across great distances to reach the nearest clinic.
Following a decade of civil war, Liberia’s health infrastructure was devastated. Only 50 doctors remained to treat a population of more than four million people. This meant that if you became sick in the city, you stood a chance. But if you got sick in the last mile, you could die anonymously of a treatable condition like malaria, a complicated childbirth, or even diarrhea.
The last 25 years have seen some progress toward global heath equity, but these advances are often not felt in remote communities. Today, more than six million children still die before their fifth birthday each year. Maternal mortality remains a top killer of women. Communicable diseases, including Ebola, HIV, and tuberculosis, have emerged to change the landscape of community health, and non-communicable diseases such as heart disease and chronic lung disease have proven difficult to manage in remote areas. In recent past, the world has made significant gains in improving global health delivery, but progress has been slow to reach the last mile.
Innovation and Activities
Last Mile Health was founded in 2007 to overcome the challenges of remote healthcare delivery and ensure access to lifesaving care for all people living in remote communities, defined as those more than five kilometers from the nearest health facility. The organization recruits, trains, equips, manages and pays professionalized CHWs who deliver high-quality care to their neighbors and fellow community members living in the last mile. CHWs take the services traditionally provided in hospitals and clinics and bring them to patients’ doorsteps. These community-based outpatient services ensure that people living in remote communities have access to the healthcare they need to end preventable deaths.
Since Last Mile Health was founded, the organization has demonstrated impressive impact. Last Mile Health successfully launched Liberia’s first community-based rural HIV treatment program in Konobo District, which has since been scaled by the government to more than 19 sites nationally. Meanwhile, Last Mile Health’s CHW program in Konobo has achieved dramatic gains in access to care for women and children, including an increase in maternal facility-based deliveries from 56 percent in 2012 to 96 percent in 2015.
In addition to training and deploying CHWs in Grand Gedeh and Rivercess Counties, Last Mile Health is now serving as a technical assistance partner to the Liberia Ministry of Health, supporting the government to develop and implement a nationwide CHW program - to be known as the National Community Health Assistant (CHA) Program - aimed at ensuring that ALL Liberians living in the last mile have access to lifesaving care, no matter how far they live from the nearest clinic. This historic program will deploy over 4,000 community health professionals to reach 1.2 million Liberians.
Dr. Raj Panjabi is CEO of Last Mile Health and Associate Physician in the Division of Global Health Equity at Brigham and Women’s Hospital and Harvard Medical School. At age 9, Dr. Panjabi escaped a civil war in his home country of Liberia. He returned as a 24- year-old medical student to serve the people he had left behind and co-founded Last Mile Health. Last Mile Health saves lives in the world’s most remote communities by partnering with governments to design, scale, and advocate for national networks of community health professionals. Last Mile Health’s work has been published in the Lancet, the Journal of the American Medical Association, and PLoS Medicine and has been featured by TIME, Fortune, Forbes, the Wall Street Journal, NPR, and the New York Times. In 2016, TIME Magazine named Dr. Panjabi to its annual list of the “100 Most Influential People in the World”, with a tribute from President Bill Clinton. In 2015, Fortune Magazine named Dr. Panjabi one of the “World’s 50 Greatest Leaders,” recognizing Last Mile Health’s work to support the Liberian Government to build a national community health workforce. Dr. Panjabi is a Forbes 400 Philanthropy Fellow, a Draper Richards Kaplan Foundation Social Entrepreneur, and an Echoing Green Fellow. He is a recipient of the Clinton Global Citizen Award, Outstanding Recent Alumni Award from Johns Hopkins, the Distinguished Young Alumni Award from the University of North Carolina, and the Global Citizen Movement Award. Dr. Panjabi is a graduate of the University of North Carolina School of Medicine, received a Masters of Public Health from the Johns Hopkins Bloomberg School of Public Health, and was a Clinical Fellow at Harvard Medical School and the Massachusetts General Hospital.
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