Sustaining chw programs: Successes and challenges

400 million rural Africans go their entire lives without seeing a health worker. It has never been clearer that new solutions to village health delivery are desperately needed. Community health workers are the first and often the only point of contact to the health care system for millions of people in remote villages and represent Africa's largest health workforce.

Unfortunately, while village health workers have been recognized as solutions with potential for high impact, they remain undervalued by health systems. A combination of insufficient investment and lack of innovation has prevented rural community health workers from reaching their full potential to save lives in remote villages. Tiyatien Health (TH) is a local NGO that has designed and implemented a new, professionalized CHW model to bring quality healthcare services to the most remote populations of Liberia. We:

RECRUIT - TH has modernized FHW recruitment with a 5-step participatory algorithm that assesses each candidate's success in preliminary training and hires only the most qualified.

TRAIN - TH provides ongoing training, rigorous evaluation and regular, one-on-one coaching in the field.

EQUIP - TH equips CHWs with the tools to deliver unprecedented home-based services.

INTEGRATE – TH's CHWs are integrated with the Ministry of Health, receive clinical support, and seamlessly refer patients to clinics for advanced care.

SUPERVISE – TH's CHWs are supervised by nurses who ensure high-quality care through close management and performance evaluations.

INCENTIVIZE - TH provides CHWs with performance-based incentives that motivate and reward the most successful.