Updated Jan 15, 2021

Anina Tweed

Community Health Workers Providing Door to Door Healthcare

Living Goods’ vision is a world where every family can easily access the healthcare they need to survive and thrive. The organization achieves this by supporting networks of government-supported, tech-enabled, performance-driven community health workers (CHWs) to go door-to-door teaching families how to improve their health and diagnosing, treating, and/or referring children for basic illness. ...
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Living Goods’ vision is a world where every family can easily access the healthcare they need to survive and thrive. The organization achieves this by supporting networks of government-supported, tech-enabled, performance-driven community health workers (CHWs) to go door-to-door teaching families how to improve their health and diagnosing, treating, and/or referring children for basic illness. Living Goods-supported CHWs focus on: 1. Defeating childhood diseases: CHWs educate families on how to prevent the leading killers of children under-five: malaria, diarrheal disease, and pneumonia. When a child falls ill, Living Goods-supported CHWs provide prompt diagnosis using our smart Android app. They are equipped with key tools such as rapid diagnostic tests for malaria along with essential medicines to safely treat the illnesses they find. The app sends automatic daily text reminders to ensure patients complete the full course of treatment. The system flags acute cases for immediate referral to a qualified facility. CHWs follow up with referrals within 48 hours to ensure the patients received proper care and are fully recovered. We focus on kids under five and especially newborns, who are at the greatest risk. 2. Healthy pregnancies and saving newborn lives: Through regular home visits, CHWs identify pregnancies early, educate moms on maternal health and nutrition, and register each mother on our mobile system to receive automated text messages every week, with advice timed to their delivery date. CHWs use the App to flag risk factors and danger signs, and immediately refer high-risk pregnancies to a proper facility. CHWs visit new moms as soon as possible after delivery to ensure that the baby is immediately and exclusively breastfed, kept warm, and remains free from infection. We also provide small financial incentives for each registration and for postnatal visits. 3. Family Planning: To help women plan and space their pregnancies, CHWs provide comprehensive family planning education and provide contraceptives. Women are counseled on the full range of family planning methods available to them, and CHWs can provide a range of options including hormonal pills, emergency contraceptives and condoms, and refer to facilities for longer-term methods such as implants or IUDs. In Uganda, CHWs are also permitted by government to provide women with the three month injectable Sayana Press (DMPA-SC); in Kenya, we have plans to conduct a research initiative using Sayana Press to provide government with data on incorporating this method into their national plan, too. 4. Nutrition: Stunting, a serious consequence of malnutrition, affects over 40 percent of children in Africa and India. The lack of simple micronutrients like vitamin A contributes to over half of under-five deaths. For these reasons, Living Goods places a major emphasis on improving child nutrition. Our CHWs promote exclusive breastfeeding for the first six months of life—the best nutrition a mother can offer her newborn child. We provide at-home education on a healthy diet and focus on improving micro-nutrient intake during pregnancy and in the vital period from six to 25 months. 5. Immunization: Living Goods-supported CHWs drive the uptake and equity of immunization coverage by counselling families on the importance of receiving childhood immunizations, referring them to receive vaccinations, tracking which children are vaccinated, and following up to ensure immunizations are received. In addition to supporting CHWs to extend immunization to the community level, Living Goods also serves as an advisor to governments on how to further scale community-based vaccination programs, roll out new vaccines, as well as shape immunization budgeting and strategy development.
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Prevention
  

Stage 6: Sustained Scale

Randomized evaluations are the gold standard in evaluation design. In 2014, A large-scale, randomized evaluation of Living Goods’ and our partner BRAC’s community health program in Uganda showed substantial impact in reducing unnecessary deaths. After three years, results demonstrated a 27 percent reduction in under-five mortality at an estimated average cost of $68 per life-year saved. Infant and neonatal—under 1 month—mortality were also significantly reduced by 33 and 27 percent, respectively. The Children’s Investment Fund Foundation funded the independent evaluation led by a team affiliated with IPA and J-PAL. The RCT found that the community health program improved other intermediate outcomes as well, including improved health access, health knowledge, and behaviors. For example, households with a newborn baby were 71 percent more likely to have received a visit in the first week after birth.
Registered in Ugandain Uganda

Focus Areas:

Health, Nutrition, Maternal Newborn and Child Health and 9 MoreSEE ALL

Health, Nutrition, Maternal Newborn and Child Health, Energy, Gender, Water Sanitation and Hygiene (WASH), Clean Cooking, Energy Efficiency, Economic Empowerment, Agriculture Water Management, Social and Behavior Change and InclusionSEE LESS

Implemented In:

Kenya and Uganda

Kenya and UgandaSEE LESS

2
Countries Implemented In
Verified Funding
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Problem

We live in an age of medical and technological miracles, yet 6 million children still die each year from preventable causes. One billion people in the developing world lack access to healthcare, and an estimated 750,000 to 1 million CHWs are still required in sub-Saharan Africa alone to meet the need. As a result, millions are forced to settle for health systems that are chronically under-funded, under- stocked, and under-managed. This disproportionately affects women and their children. Each of these problems increases at the “last mile,” for the hardest-to-reach rural communities, where the need is often greatest.

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Solution

In the context of this broken healthcare system, CHWs are the first and only link to healthcare for many people across the developing world. CHWs are community members with basic health training who proactively address the essential health needs of their neighbors. They are trusted, knowledgeable, frontline health workers who often come from and live in the communities they serve. While they do not have the same highly skilled training as a nurse or doctor, CHWs bridge cultural, geographical, and linguistic barriers and still effectively address a wide range of their community’s basic and preventative health needs. CHWs expand access to healthcare and education by proactively bringing essential health services to their neighbors’ doorsteps at a fraction of the cost of facility-based care. Unfortunately, few CHW platforms have reached the scale needed to significantly improve health outcomes. A recent assessment of the Kenyan community health strategy, for example, found that high workloads, lack of accountability, low pay, and insufficient supervision render government-managed CHWs ineffective. Despite heavy reliance on CHWs in places like sub-Saharan Africa and South Asia, the current status quo is that CHWs are not properly paid, managed, trained, or equipped. Living Goods knows that with the right support, however, CHWs can reach their full potential. CHWs have been proven to save lives, increase access to care, contain health crises, and keep healthcare affordable, all while delivering a positive economic return, reducing unemployment, and empowering women.5 It is estimated that 90% population coverage by CHWs in key countries by 2020 could save ~2.5 million lives and produce a 10:1 return on investment.5 Thriving communities have the chance to thrive economically. Healthy families mean more children are in school, women have more time to dedicate to their work, and communities become more productive and thrive. With access to basic healthcare, children get a real shot at reaching their full potential and women gain more agency over their own lives and the future of their families. Living Goods’ solution is a new approach for managing and supporting government CHWs that delivers dramatically better health outcomes at significantly lower cost than alternatives. This game-changing approach reimagines community health systems by blending the best practices and research from public health with effective performance management and incentives from the business sector, a powerful mobile platform, and support to government partners to strengthen health systems.

Target Beneficiaries

Baby under five and pregnant mothers

Mission and Vision

Living Goods saves lives at scale by supporting digitally empowered community health workers who deliver care on call–making it easy for families in need to get the care they need. We envision a world where every family can easily access the healthcare they need to survive and thrive.
Funding Goal30,000,000

Milestone

Sep 2018
Funds RaisedPENDING
$5,500,000
TYPEGrant
ORGANIZATIONGAVIGAVI
Jun 2018
New Country Implemented In
Kenya and Uganda
Date Unknown
Created
Date Unknown
Recognition ReceivedVERIFIED
Profiled Innovation - Silver