2020 was a year like none other. In some ways, I think it could be described as both Living Goods’ best and toughest year. We had planned for a year of expansion—starting operations in several new countries, deepening our learnings and refining our approaches for helping others through technical assistance and government advisory services. But, despite our best-laid plans, the unfolding COVID-19 crisis forced us to quickly pivot.

The crisis coalesced the team at Living Goods like never before. From early March, we were laser-focused on the goals of keeping our staff, CHWs and the communities they serve safe; ensuring essential health services were maintained to avoid repeating the grave costs of Ebola in West Africa—where more people actually died from malaria and health system disruption than Ebola itself; and identifying the best ways to support government partners wherever we worked. We swiftly made various program modifications to achieve these goals, including free essential medicines for communities, simplified compensation structures, and modified digital technology to enable distanced assessments and supervision.

I am so proud of the team that were willing to fail fast and try new things—because the results truly paid off. As expected we saw declines in the number of families who sought facility-based care for common childhood illnesses due to various constraints related to COVID-19, CHWs were able to fill this  critical health system gap—and we have estimated conservatively this saved 20,000 to 35,000 lives in 2020.

I’m also grateful that a silver lining of this crisis is that it deepened government appreciation for how integral effective community health programs are for delivering primary health care, achieving Universal Health Coverage (UHC), and building resilient health systems that are better prepared for the next inevitable shock. Community health must not be considered as a salve for those who cannot afford more; rather, it provides a gold standard of personal, affordable and accessible health care close to home, while enabling facilities to focus on those who need them most. As told first-hand by Kenyan and Ugandan mothers throughout this report, they turn to CHWs first not only because of their close proximity, diagnostics and treatments, but because they offer personalized care that enables unparalleled trust when it matters most: changing public health behaviors amid the evolving crisis.

In turn, we’ve never seen CHWs more motivated or feel more accountable to their communities. I am beyond grateful to each and every CHW for their dedication—as they’ve saved tens of thousands of lives when it mattered most.

2020 also made clear why partnerships and collaboration are so vital, as we’ve made significant inroads this year in enabling the adoption of best practices in community health, supportive policies and legislation, and protecting and effectively equipping CHWs.

We are fortunate that in 2020, things got to the worst-case scenarios we prepared for when COVID-19 hit. But the pandemic is not over. Cases are increasing in Africa, new strains are emerging, and the continent’s vaccination plans are behind other parts of the world. CHWs will play many critical roles this year as COVID-19 vaccination campaigns roll out, and we are committed to supporting those efforts. The trust they’ve engendered in their communities will be essential for ensuring people understand side effects and that vaccines reach the last mile.

Finally, let me mention the work we have done on diversity, equity and inclusion (DEI) since last year. DEI has been a culture priority since 2019, not because anything was broken but because we knew we could do even better than before. In the second half of 2020, we carried out an organization-wide diagnostic of enablers and derailers of inclusion and belonging at Living Goods, interviewing 45 key informants across our staff and board, 7 focus group discussions and surveying all staff surveys. The employee-led action planning process is in progress to  translate the rich insights into clear measurable action plans that the Board and my team will start to implement this year.

Thanks again to all the CHWs who tirelessly supported their communities, to our funders who allowed us to shift spending to our COVID-19 response, to partners who worked with us to achieve these results, and to governments for giving us the chance to support you when you needed us most. Most of all, I am grateful to all of Living Goods’ staff, who worked so hard to ensure our most challenging year was our most impactful one.

My best to all in the coming year,

Liz Jarman

CEO, Living Goods