Living Goods has become a leading partner to governments as they digitize their community health interventions because of our unique blend of hands-on implementation expertise and extensive digital capabilities. For the last 10 years, we have pioneered the use of digital tools to rigorously monitor and continuously improve community health worker CHW performance—all in service of driving greater health outcomes.

We have learned a lot about how to do this at scale and have actively shared our expertise and evidence with governments embarking on national scaling initiatives. At the same time, we have built momentum for other crucial components necessary for an effective community health workforce.

In 2023, we saw substantial progress in adopting supportive policies for community and digital health across our three countries of operations. Additionally, governments invested in the implementation of electronic community health information systems (eCHIS), which will eventually support approximately 200,000 CHWs and reach 120 million people.

Living Goods acknowledges that countries are at varying stages and commits to providing continuous support in their journeys. Looking to 2024, we will solidify our support for eCHIS in the countries where we operate and work with governments to ensure effective policy implementation and expand our work in health financing. While we are excited about what’s to come, we recognize that the journey is far from complete, particularly in securing sustained funding for community health.

Key Milestones

In Kenya: Living Goods played a crucial role in securing the government’s commitment to digitize, train, supply, supervise, and enhance compensation for all 100,000 CHWs across the country. We estimate this will result in approximately $100M in government-directed investment in community health across the country in the first year.

At the same time, President William Ruto strengthened the nation’s healthcare infrastructure by enacting four groundbreaking bills, including the Primary Healthcare Act, The Digital Health Act, The Social Health Insurance Act, and The Facility Improvement Financing Act.

Living Goods and the Community Health Units for Universal Health Coverage (CHU4UHC) partners have long supported government efforts, providing evidence on CHW effectiveness and creating foundational documents like the Investment Case for Community Health, the Costed Community Health Policy 2020-2030, the Kenya Community Health Strategy, and a landscape analysis of digital health requirements.

While this support for community health at the highest levels of government is promising, the rapid deployment of changes poses risks. We, alongside partners like Lwala, Medic, and Johnson & Johnson are working closely with national and county governments to maximize impact and mitigate risks.

In Burkina Faso: We collaborated with the government on the costing and strategy development for the new National Community Health Strategy while implementing the Global Fund’s Project BIRCH grant. With strong government commitment and financing, the new strategy presents a significant opportunity to shape the country’s community health programming over the next five years, prioritizing eCHIS. We applaud the government’s leadership and commitment to supporting CHWs, including ensuring they are paid and appreciated.

The government announced the addition of 15,000 CHWs to serve populations who migrated to cities due to security challenges. We will assess our potential role in 2024 and evaluate how we can contribute to this expansion. Recognizing the critical importance of security concerns, especially following recent coups in Niger and Gabon, we have taken proactive measures by hiring a local consultant to guide our continued growth within the country.

In Uganda: Living Goods collaborated with the government in developing the inaugural National Community Health Strategy. This strategy emphasizes the effectiveness of digitized, well-supplied, supervised, and compensated CHWs in promoting good health.

The government also launched the Health Information and Digital Health Strategic Plan, leveraging Global Fund financing to scale up eCHIS. Selected by the Ugandan MoH to lead the rollout in six districts, we collaborated with Medic and BRAC on this project. The government aims to expand eCHIS to 30% of CHWs in 50 districts by 2025.

While this promotes standardization of care at the community level, there is currently only investment in the digital aspects. It is however not enough to put digital tools in the hands of CHWs; they must receive a full package of support to be effective, including strong supervision, continuous training and upskilling, supplies, and fair pay. We will continue to advocate for this.

At the Global Level: Living Goods recognizes the essential role of advocacy in knowledge sharing, policy influence, and translating commitments into action for maintaining community health programs at the core of health systems strengthening.

In 2023, among many things, we successfully advocated for the incorporation of robust community health best practices within the UN Political Declaration on Universal Health Coverage and contributed to Africa CDC’s Continental Coordinating Mechanism for Community Health.

Furthermore, we shared best practices at the Community Health Worker Symposium, which concluded with the Monrovia Call to Action. This collective effort, involving government delegations worldwide, aimed to mobilize increased investment in CHWs.