How Living Goods is Working to Transform Community Health
Working side-by-side with committed governments, implementers, and funders, we aim to ensure there is a digitally empowered community health worker (CHW) in every community. With our support, these local women and men are transformed into frontline health workers who can deliver on-demand, life-saving care to families in need. They go door-to-door treating sick children, supporting pregnant mothers, counseling women on modern family planning choices, educating families on better health, and delivering high-impact medicines. A rigorous 2014 study in Uganda found that the CHWs we support decreased child deaths by 27 percent for less than $2 per person annually.
Living Goods uses data-driven performance management, incentive systems, regular in-service training, and supportive supervision to help governments ensure CHWs can deliver high-quality primary health care services. Our work is made possible both by donors and by governments that contract us directly.
Beyond direct program implementation, Living Goods is also increasingly involved in interrelated efforts to strengthen local health systems, including advocating for increased investments in community health systems, integrating best practices into policies and practice, supporting the development of mHealth platforms, and catalyzing innovations, research, and health financing that strengthen community health services.
Six key elements define our approach and drive our impact
1. Empower Community Health Workers to Deliver On-Demand
Digitally empowered CHWs help patients receive care when and where they need it. Rather than trudge to a distant health facility, wait in line, and hope the drugs they need are in stock, families can instead call their CHW whenever someone is sick. The CHW will come to their door, use a simple smartphone app to ensure an accurate diagnosis, and—in many cases—provide trusted, high-quality medicines on the spot. Delivering basic care to the home is far more practical for patients and greatly improves uptake and outcomes. Patients get treated much sooner, too, so illnesses are much less likely to worsen.
More than 90 percent of Living Goods-supported CHWs in Uganda are women (more than 70 percent in Kenya), which means our approach to community health is also a powerful engine for women’s economic empowerment. We provide both financial and non-financial incentives for CHWs, including pay linked to how they perform. In some cases, we also provide our supported CHWs with a small margin on the sales of medicines and other health-related products.
2. Collaborate with Countries to Achieve National Impact
We partner closely with country governments in Kenya and Uganda and their partners to strengthen the quality, efficiency, and scope of services delivered by CHWs. We always adapt to local priorities and contexts. We don’t do short-term projects; instead, we help to build sustainable systems for the long term. We help shape policies that expand the services CHWs can provide, the support they need, and the financing required.
“Through this partnership, [CHWs] will help prevent diseases at the community level through sensitizing locals on proper hygiene practices, public health initiatives, immunization counseling, check-ups, and ante-natal services to reduce the high maternal mortality rates in the region.”
– Isiolo County Governor Dr. Mohamed Kuti
3. Employ Rigorous Performance Management and Smart Incentives
We work closely with government and local administrators to select motivated and talented CHWs and supervisors who will benefit most from our support. We set clear monthly targets for every CHW using carefully selected health metrics and compensate them for results, providing a financial incentive tied to hitting their activity. Their compensation is primarily based on meeting their activity; in some places, we help CHWs earn more by selling high-impact health products such as healthy fortified foods and solar lights.
Finally, our powerful mobile platform captures data on every patient, allowing us to verify that what was reported was actually done. The mobile health—or mHealth—technology solutions we employ provide supervisors with accurate data to deliver real-time feedback to thousands of remote CHWs.
4. Leverage Disruptive Mobile Technology
Virtually every sector—from books, to retail, to transportation—has been positively reinvented by mobile technology. The same kinds of technology can now be used to reinvent community health on a game-changing scale. If you put a smartphone in the hands of every community health worker, you transform the work of every link in the health care chain.
Our digital tools:
- Support Families by providing quality on-demand health care to their doorsteps.
- Enable CHWs to deliver accurate diagnoses and timely follow-ups.
- Equip Supervisors with real-time visibility on CHW performance (against previously established targets) to provide faster, smarter performance management that leads to better outcomes.
- Empower Health Ministries with accurate data to hold people accountable, gain insights on community health to make better policy decisions, and get early warnings on deadly vectors to prevent epidemics.
- Assure Funders with a high level of transparency and accountability. The system captures every data point in real-time with patients’ names, mobile numbers, and GPS locations, which can be easily audited.
5. Our Integrated Platform Avoids Inefficiencies of Single-Issue Health Strategies
In many places, uncoordinated actors build separate systems, duplicating effort and investment. At Living Goods, we help partners build an integrated platform to address the high-impact health needs identified at the community level. This saves governments and funders a tremendous amount of money and gives families one person they can call for all their basic health needs. Rather than focus on just a single disease, the CHWs we support register every pregnant woman, conduct pre- and post-natal visits, treat sick children, provide family planning counseling, and track immunizations. This scope will expand and evolve as communities’ needs do.
6. Ensure Access to Life-Saving Drugs
To save lives, CHWs must have access to basic medicines to treat the most common killer diseases and family planning commodities. Frequent lapses in stock represent one of the biggest challenges facing public health systems. In most of our direct operations, Living Goods works to ensure essential medicines and family planning commodities are in stock 100 percent of the time.
We track inventory levels electronically in real time to foresee and prevent stock-outs. We also developed a delivery service that enables CHWs to order by phone and have products delivered by motorbike, reducing both time and expense. We also seek opportunities to support governments in any capacity when they want to manage their own supply chains and to directly provide CHWs with free public sector medicines and family planning commodities, as we do in our partnership with the government of Isiolo County, Kenya.