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Last Mile Health and Living Goods’ Audacious Project

October 12, 2018

The 2017 “Scaling Solutions” report profiled the achievements of Last Mile Health (LMH) in Liberia. Since then, the organization has announced an exciting new partnership with Living Goods (LG) as part of the Audacious Project.

The use of mobile technology to enable service delivery is long overdue, especially in healthcare and education. Digital technology enables health workers to diagnose and treat people by using data and algorithms that help them ask the right questions in the right order.

Both LG and LMH have strong government partnerships, from the national to the local level. But whereas LMH prioritizes government-led implementation, LG runs the entire program end to end in 70 percent of the places it works. “We approve health workers, we train them, we have the supply chain, and we contract with the government to do this work. This is our direct approach,” explains an LG representative.

Every health worker LG supports gets names, locations, and treatments with a time stamp. Everyone can see a treatment in real time, whereas it used to take four to eight weeks to advise someone in the field. Now people can optimize their chances to save lives every time they open their app. Funders can see the same level of transparency of the work in real time, with a third party auditing the data and the services delivered in real time. This will become the enabling architecture for results-based funding that makes it possible to invest with less risk because people can pay for an actual outcome.

LG is trying to reinvent community-delivered healthcare on a national basis. Eighty percent of its work is in two countries: Uganda and Kenya (70 million people). From the beginning, LG has had a policy and strategy of focusing on unrestricted funding. Of the funding it has raised in the last 10 years, 85 percent has been unrestricted, and it will continue to increase unrestricted funding.

As for LMH, it honed a model to expand access to primary healthcare for remote communities in Liberia via community health workers, and then partnered with the government to scale this work nationwide. However one billion people worldwide lack access to health due to distance. LMH alone can’t serve them, and believes that governments should also lead the way. The philosophy at LMH is to scale its impact, not its organization. Therefore, LMH is committed to looking at how to change policy, standardize operations, and identify financing to ensure programming is sustainable.

A group called The Audacious Project has committed to a matching grant for LG and LMH. The grant was drafted with a four-year commitment, and the funders are tracking targets such as family planning, population reach, and cost analysis. The $50 million matching grant includes $15 million for LMH and $35 million for LG.

As part of the Audacious Project, LMH will be launching in one to two new countries, and LG will launch in two or three new countries, likely without any overlap. Both of their leadership teams have done learning exchanges about what each organization does well. LMH considers how LG’s use of data, research, and supervision can be adopted in the countries it serves, and LG can learn from LMH about collaboration with government. Overall, the partnership aims to deploy over 50,000 community health workers to reach 34 million people across six countries by 2021.

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