Until no Patient is out of Reach:

15 years
Of Last Mile Health

Our Vision

Our vision is a world where a health worker is within reach of everyone, everywhere. Here’s what that world could look like in one remote community.
Picture this:

It’s early morning as you set off down the path. Already, the sun is warm on your shoulders, and you have a busy day ahead. As the only community health worker for miles around, your entire community depends on you. There’s the young couple eager to welcome their first child: the expectant mother relies on you to conduct her antenatal checkups, and when the time comes, you’ll help coordinate her transport to the nearest clinic for her delivery.

There’s the little boy from the home next to herslast month his mother noticed he had a fever, and you used a rapid diagnostic test to diagnose him with malaria and then provided treatment right in his own home.

And there’s your closest neighbor, a mother of three whose youngest child was born just three months ago at the health facility. Today, she and her baby girl will be the first patients you visit.

When you arrive, your neighbor welcomes you in. She answers your questions about her health and the health of her baby, and she wants to know—Is my daughter growing the way she should be? Is she getting enough to eat? To check for malnutrition, you use a measuring tape to perform a middle-upper arm circumference screening, a skill you learned when you first trained to become a community health worker.

To help your neighbor understand the test, you take out your tablet and find a video that shows a mother like her with her own baby. Last month, when you completed your regular refresher training, the facilitator shared this resource with you. Today, when you share it with your neighbor, she’s reassured: like the baby in the video, her daughter’s arm measurement falls within the green section of the tape. She’s growing just the way she should be.

Before you leave your neighbor’s house, you switch to the case management portal on your tablet. When you first started working, you had to fill out paper forms for every visit to every patienta time-consuming process. But now, you easily manage each case on a digital health system. When you meet with your supervisor next week, she will help you look at any tricky cases where you want support, and she’ll make sure you’ve submitted your patient reports.

If there is an outbreak of TB, malaria, or even a new sickness, the Ministry of Health will notice it, your supervisor explains, emphasizing that you’re part of a well-connected system that covers communities in every district of the country. Through thousands of community health workers’ reports, the Ministry tracks healthcare coverage, identifies potential health threats, and gets a bigger picture of the changes that have happened in communities like yours. They’ll use the data to refine the systems, trainings, and practices that support you, ensuring you can provide even better care. They’ll also make certain you get the supplies you need to care for your patients.

As you leave your neighbor’s house, you are happy to know her baby is thrivingand you’re proud that the family trusts your advice. They know you have been trained to give them the care they needand that you are their link to the health system. You are proud of the work you do and the changes you’ve seen. The salary you earn helps pay for your own children’s school fees, and your oldest child tells you she wants to be a health worker like you someday. She tells you, I want to help people, like you do.

There’s a long day ahead. Already, you’re thinking of your next patient. There is more work to be done, today and every day. But seeing your neighbors healthy and happy drives youand makes your journey worthwhile.

You walk on.

A future where care is within reach

For 15 years, Last Mile Health has worked tirelessly to realize a world where high-quality, dignified care is accessible to all. Where stories like the one above are not an outlier, but the daily reality in every rural and remote community.

We know that realizing our vision starts by investing in community health workers who are skilled, salaried, supplied, and supervised as part of national programs operating at scale and backed by strong data and financing systems. This vision has become the reality in many communities where it wasn’t 15 years agoand it changes health outcomes every day. Just ask Marie Gboto in Liberia, a mother whose son recently recovered from malaria thanks to the treatment provided by community health worker Laura Gbee. Or Workinesh Getachew, a community health worker in Ethiopia recently promoted to district supervisor thanks to her hard work to master the skills and knowledge she gained in her in-person and digital training sessionsand applied each day as she cared for her patients. Frontline health workers like Laura and Workinesh are bringing care within reach for more people each year, supported by national ministries of health, Last Mile Health, and our funding partnersbut much remains to be done.

We’ve learned what it takes to build exemplar community health systemsbut our work is just beginning. Here’s how we’re leveraging what we’ve learned to come closer to a future where no patient is out of reach.

Our Track Record

Last Mile Health began with the vision of bringing justice in health to those living in the world’s most remote communities. Today, this vision is unchanged. Follow Last Mile Health’s journey through our first 15 years delivering quality care, training community health workers, and strengthening health systems as we work toward a future where everyone, everywhere has access to the care they need.
Founding Last Mile Health
Last Mile Health is founded by Liberian civil war survivors and American health workers under the name Tiyatien Health, which means “justice in health” in a local dialect.
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Fueled by the belief that no patient should remain out of reach, our founders launch Liberia’s first rural, public HIV treatment program. We partner with the Government of Liberia and the Global Fund to Fight AIDS, Tuberculosis, and Malaria to replicate our HIV treatment model in 19 public clinics across 12 of Liberia’s 15 counties.
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We realize that to reach patients living in remote communities, we need to serve them directly in their homes. We partner with the Government of Liberia to pilot a community health worker program in Konobo District, one of the country’s hardest-to-reach regions. The pilot significantly increases uptake of maternal and child health services, building evidence and hope for other remote regions in Liberia.
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In partnership with the Government of Liberia, we train more than 1,300 health workers and community members to educate communities, refer patients to care, and contain the spread of Ebola. Primary health services, which had all but shut down across Liberia, are never disrupted in the communities where we work.
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In partnership with Liberia’s Ministry of Health and peer organizations, we design and launch the country’s first-ever national community health worker program, the National Community Health Assistant Program, to extend primary healthcare to 1.2 million people living at Liberia’s last mile through paid, professionalized community health workers. After launching the national program in Rivercess County, the proportion of children receiving care from a qualified provider increases substantially.
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Last Mile Health co-founder Dr. Raj Panjabi accepts the 2017 TED Prize and shares the story of Last Mile Health in a TED Talk. He announces plans to launch the Community Health Academy, which leverages open-source digital tools that improve the efficacy and efficiency of training. The Academy reflects Last Mile Health’s growing work in partnering with ministries of health to strengthen community health workers’ skills. As of October 2022, over 40,000 learners have accessed course content for health leaders from the Academy.
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Last Mile Health and like-minded organizations found the Community Health Impact Coalition, advocating for the professionalization and payment of community health workers. Together, we contribute to the World Health Organization’s first community health worker guidelines, calling for all community health workers to be fairly paid for their life saving work.
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We launch a new three-year strategic plan, Within Reach, which outlines our commitment to deepen our work in Liberia while partnering with governments to strengthen three additional national community health programs to serve as global exemplars. Within Reach also reaffirms our commitment to sharing our best practices and lessons learned with the global health community. We launch a new partnership with the Malawi Ministry of Health to help ensure the National Community Health Strategy delivers essential primary health services to every person, no matter where they live.
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We launch a comprehensive effort to support governments to deploy community and frontline health workers to prevent, detect, and respond to the coronavirus, while ensuring patients have uninterrupted access to primary healthcare. Our partnerships support the delivery of 6.2 million pieces of personal protective equipment, and over 14,000 health professionals download courses available through our COVID-19 applications in Ethiopia, Sierra Leone, and Uganda. We also advise global guidelines for community health workers responding to the pandemic with partners like the Africa CDC.
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Building on the success of our COVID-19 applications for health workers, we partner with Ethiopia’s Ministry of Health to design and pilot an innovative blended learning training module for community health workers, combining in-person and digital training sessions to keep learning and engagement high while making training more affordable. Results demonstrate that blended training learners’ knowledge scores improve at least as much as in-person learners, while costs drop by 39%.
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Building on what we’ve learned through our flagship program in Liberia, we deepen our work in our partner countries, leveraging our Theory of Change to maximize impact by working across three levels: delivering care, upskilling health workers, and strengthening the community health system. We deepen our partnerships with the Ministries of Health in Ethiopia, Liberia, Malawi, and Sierra Leone to develop and scale community health worker programs at the national level. As of October 2022, we support 8,308 community and frontline health workers who provide care to more than 5.6 million people in rural and remote communities.
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We reinforce and build on our commitment to ensuring Last Mile Health is inclusive and equitableboth in our work and within our organization. We open a new global office in Accra, Ghana to move centers of power and decision-making closer to our programming, and to provide stronger technical assistance to our country programs. We also launch our new Diversity, Equity, and Inclusion (DEI) roadmap, which defines clear activities to advance DEI at Last Mile Health by changing our policies, systems, programs, and culture.
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Our Theory of Change

After 15 years of impact, the question is no longer why we should invest in community health workers: it is how to ensure community health workers can deliver high-quality health services at scale.

This starts with partnering with governments to prioritize, finance, and implement strong community health programs that can achieve long-term sustainability and impact. These systems support community health workforces that are skilled, supplied, supervised, and salaried, operating at national scale, and integrated into broader public systems via data and financing (we call these the Six Ss).

Today, Last Mile Health partners with ministries of health in Ethiopia, Liberia, Malawi, and Sierra Leone to skill, supply, salary, and supervise 8,308 community and frontline health workers to serve 5.6 million people. In each country, we tailor our work with government to catalyze an exemplar community health system by working across the three levels of our Theory of Change:

Strengthen health systems:

Advocate for and advise governments to build and sustain responsive, resilient, and well-financed community health systems that embody the Six Ss and reach all communities.

Upskill the community health workforce:

Train and grow the community health workforce to manage and sustain high-quality community-based primary care.

Deliver high-quality community-based health care:

Demonstrate effective community-based primary care that leads to improved health equity and outcomes in rural and remote communities.

All of this work is done in service of patients, ensuring they have access to the quality care they deserve, each and every day.


By the numbers
who were supervised, skilled, supplied, or salaried in partnership between a Ministry of Health and Last Mile Health
5.6 Million +
People Served
by those community and frontline health workers

We work with governments to build community health programs that are durable, high-quality, and data-driven. Through global advocacy and direct partnership with ministries of health, we work to ensure community health workers are skilled, salaried, supervised, and supplied as part of programs operating at national scale and integrated into national data and financing systems.

This year, our work to strengthen health systems has centered on two key efforts: digitizing Malawi’s national community health system to improve the quality, accessibility, and monitoring and evaluation of primary care delivery; and building from our country-level financing work to launch the Africa Frontline First initiative to increase the community health workforce in up to ten countries across Africa.


In partnership with the Ministry of Health, we’re digitizing Malawi’s community health system to improve primary care delivery at the last mile.
As a core partner in Africa Frontline First, we’re working in coalition to influence how $2 billion in sustainable funding is invested in community health programs across Africa.


By the numbers
Number of rural and remote community and frontline health workers
who have accessed Last Mile Health training content:

In partnership with governments, we upskill and grow the community health workforce to increase their performance and deliver high-quality primary healthcare. We work to ensure community and frontline health workers acquire and apply new knowledge and skills in primary care delivery, and we support health leaders to acquire and apply expertise to manage community health systems.

This year, our upskilling work has included two exciting initiatives: ensuring the quality of the pre-service training of Sierra Leone’s first fully-integrated national cohort of community health workers and developing an innovative new blended learning training module for community health workers in Ethiopia.

community health workers accessed blended refresher training module on reproductive, maternal, neonatal, and child health in Ethiopia
community and frontline health workers accessed the COVID-19 digital course series in Sierra Leone
community health workers trained to use the integrated Community Health Information System (iCHIS) in Malawi
community health workers accessed refresher training on maternal and child nutrition in Liberia


With a revised curriculum and strengthened monitoring and evaluation, we’re upskilling a new cohort of over 8,000 community health workers in Sierra Leone to provide a fully integrated package of primary care services to patients in remote communities.
Building on the success of our COVID-19 health worker training app, we’re using technology to pilot innovative, culturally sensitive, and cost-effective refresher training for over 1,000 community health workers in Ethiopia.


By the numbers

We work in partnership with governments to deliver effective community-based primary healthcare at the last mile. Community health workers supported by Last Mile Health provide high-quality care to their neighbors right at their doorsteps.

In one county served by the Liberia Ministry of Health and Last Mile Health, care for childhood illness by a qualified provider increased by 60.3 percentage points when professional community health workers were deployedmeaning more children are happy and healthy.

in Liberia since the launch of the National Community Health Assistant Program in 2016
Children ages 12-23 months receiving full course of pentavalent immunizations
in Rivercess County, Liberia
in Last Mile Health’s managed counties:
in Grand Bassa County
in Konobo District (Grand Gedeh County)
in Gboe Ploe District (Grand Gedeh County)
in Rivercess County
in Last Mile Health’s managed counties:
in Grand Bassa County
in Konobo District (Grand Gedeh County)
in Gboe Ploe District (Grand Gedeh County)
in Rivercess County


In partnership with Liberia’s Ministry of Health, we’re transforming access to healthcare through the implementation of the National Community Health Assistant Program. The results are compellingboth through studies demonstrating their quantified impact, and through the stories of patients like Marie Gboto and her son Samuel, whose lives have been changed by access to primary care in their community.

Here's What's Next

Working to build better health systems to ensure a healthier future–for all.

At a United Nations General Assembly side event co-hosted by Last Mile Health, the Community Health Impact Coalition, and Women in Global Health, Liberian community health worker Ruth David raised a call to action:
I am requesting that the numbers of community health workers increase in Liberia and around the world.

Each day, we are working to answer Ruth’s call: equipping community health workers with the supplies and support they need to deliver high quality care, upskilling new and experienced health workers to grow and sustain the community health workforce, and strengthening health systems to scale and sustain exemplar community health programs. We’re proud of the work we have helped make possible–and inspired by the partnership of the health workers, health systems leaders, financing partners, and peer organizations we stand alongside each day in our fight to bring healthcare within reach for all. Much work remains to be done–and we’ve made it our mission to close the distance to care for those living in the world’s most remote communities.

Looking forward:
Our New Strategy

The past 15 years have been marked by incredible progress in the community health movement.

There is a growing evidence base underscoring the vital role community health workers play in improving maternal health services, reducing infant mortality, and maintaining access to care during crises like COVID-19. There is growing demand for health services from patients living in last mile communities, and public sector partners are increasingly adopting community health policies. But there is also growing urgency, as the pandemic continues to exacerbate inequities that result in two billion people living outside the reach of the health system.

We can close that distance when we invest in community health workers and the systems that support themand that’s exactly what we’re committing to do in our new strategic plan, Closing the Distance. Over the next five years, we will deepen our impact in four to six national community health systems to bring essential primary care to last mile communities, and we will influence community health financing across Africa to improve how $2 billion in sustainable funding is invested for the greatest impact at the last mile.

Here’s what We're Doing Next.

We will work to increase the financing available for national community health programs globally, while partnering directly with four to six African governments to realize exemplar community health systems that meet the Six S framework.
  • At the country level, we will accompany governments to build and sustain responsive, resilient, and well-financed community health systems that reach all communities. We will tailor our efforts in partnership with governments to strengthen one or more of the Six Ss as aligned with the country’s community health program, policy, and priorities, resulting in higher-quality care for patients.

  • At the global level, we will continue our work as a founding member of the Africa Frontline First initiative to catalyze $2 billion in new investments for community health by 2030, enabling 200,000 new professionalized community health workers to expand healthcare access for 100 million people across 10 countries.

We will work to upskill the community health workforce by increasing the skills and knowledge required to deliver and maintain high-quality care for patients.
  • We will partner with four governments to design curricula and blended learning training modules; facilitate engaging and effective training for community health workers; and measure improvements in skills, knowledge, and cost-effectiveness. For example, in Ethiopia, we’ll continue to expand our innovative blended learning training, with the potential to reach up to 44,000 community health workers. In Sierra Leone, we’ll partner with the Ministry of Health and Sanitation to train over 8,000 community health workers to deliver an integrated service package to rural and remote communities.

Community health workers deliver high-quality community-based primary care that leads to improved health equity and outcomes in rural and remote communities historically outside of the reach of care.
  • We were founded to bring care within reach of patients living in remote communities, and we will build on 15 years of direct service delivery work in Liberia to continue to expand access to care, measure impact, and deepen quality of services. We will evaluate the impact of service delivery innovations on quality of healthcare delivery and equitable access to health services, and we will grow community-led monitoring efforts.

Until no patient is out of reach

For 15 years, we’ve been working alongside our partners to bring healthcare within reach.

But change doesn’t happen overnight, it happens across generationsand to drive lasting, systemic impact in our mission to save lives in the world’s most remote communities, we must continue to invest in community health workers and the systems that enable their success.

Fifteen years is only the beginning. The journey ahead is longbut like the community health workers who walk narrow forest paths and cross dry plains each day to visit their patients and provide lifesaving primary care, we are committed to going the distance. This is about more than Last Mile Health: it’s about a global movement to realize universal health coverage, and it’s worth the work.

Together, we can close the distance.

Partners & Financials

The Question is How.
The Answer is: Together.

Last Mile Health is part of an ecosystem of committed, talented partners working together toward the same goal: health for all.

Fiscal Year 2022:
July 1, 2021 to June 30, 2022

Click here to view our most recent audited financial statements.
*The majority of LMH's cash and cash equivalents includes both the board reserve and temporarily restricted funds earmarked for specific programming and/or expense timeline.