Estimated duration
1 Years
Estimated total value
Last Mile Health; Liberian Ministry of Health and Social Welfare, Segal Family Foundation, Skoll Foundation, Ministry of Health of Ethiopia, Ministry of Health and Sanitation Sierra Leone, Co-Impact

Advancing Health & Gender Equity in Africa


Last Mile Health (LMH) committed to partnering with ministries of health in Liberia, Ethiopia, and Sierra Leone to realize a vision of a resilient health system, powered by trained, equipped, salaried, and supported community health workers (CHWS). Through designing blended-learning curriculums, introducing training in maternal and child health care, and increasing the number of paid female workers, LMH seeks to advance gender equity and strengthen health systems.


Last Mile Health (LMH) trains CHWs by partnering with governments to design curricula and training to strengthen skills and performance. By upskilling the community health workforce and increasing the number of paid CHWs, LMH strengthens health systems, delivers high-quality care, and advances gender equity.

Building from 15 years of experience, LMH will partner with the governments of Liberia, Ethiopia, and Sierra Leone to train CHWs to strengthen the delivery of primary health services to remote communities and increase the number of paid female CHWs.

In Liberia, as the lead technical partner for the national CHW program, LMH is working towards fully scaling and sustaining the national program, with a focus on increasing the number of female CHWs to strengthen quality of care for mothers and children. Building on a pioneering gender assessment, LMH and the government will evaluate the barriers for women to become paid CHWs, revise the national policy, and recruit more female CHWs.

In Ethiopia, the Ministry of Health (MOH) invited LMH to design an in-service training program for CHWs to increase performance. Leveraging the success of a reproductive, maternal, and child health pilot, LMH will scale blended training (incorporating face-to-face and digital training) to 1,000 additional CHWs over the next year–with the potential to eventually reach all 40,000 CHWs working nationwide, majority of whom are female.

In Sierra Leone, LMH is partnering with the MOH to implement a revised integrated national CHW program in the country. The integrated national program aims to train 8,700 CHWs to deliver a comprehensive service delivery package for mothers and children. LMH is a key technical partner, providing upskilling and monitoring and evaluation support.

This commitment represents a foundational investment in the lead up to Last Mile Health’s next five-year strategy, to be launched in 2023.


Half of the world’s population lacks access to essential primary healthcare (World Health Organization). This gap is particularly acute in remote communities, where two billion people live outside of the reach of healthcare (World Health Organization). This has only been exacerbated during the pandemic – for every COVID-19 death, more than two women or children have died as a result of disruptions to health systems (Global Financing Facility).

Illness is universal, access to healthcare is not. But we can change that when we invest in community health workers (CHWs), who provide primary health services to their neighbors. Studies show that training and professionalizing CHWs can save more than three million lives annually (Journal of Global Health). CHWs can maintain primary health services during crises like COVID-19, and contribute to reductions in child and maternal mortality (Exemplars in Global Health).

However globally, there are not enough paid CHWs to meet demand. There is a massive health worker shortage, with 18 million more health workers needed by 2030 (World Health Organization). Training this workforce is a crucial component of health systems strengthening, but it can be expensive and unevenly delivered, leading to significant gaps in patient care. Suboptimal training plagues CHW programs and contributes to lower job satisfaction and performance, and prevents these programs from reaching their full life-saving potential (World Health Organization). A focus on training alone isn’t sufficient to build the community health workforce – it’s also about fair pay and recognition of the critical role women play in the existing workforce. 70% of the community health workforce is female worldwide, and at least 6 million women are working unpaid or underpaid (Women in Global Health).

A healthier, safer, and more gender-equal world is within reach, and it starts with investing in high-quality training for CHWs and pathways to professionalization for women.

Progress Update

Partnership Opportunities

NOTE: This Clinton Global Initiative (CGI) Commitment to Action is made, implemented, and tracked by the partners listed. CGI is a program dedicated forging new partnerships, providing technical support, and elevating compelling models with potential to scale. CGI does not directly fund or implement these projects.