Chief Executive Officer
President & Chief Operating Officer
In 1990, four out of every ten Ethiopians lacked access to healthcare and maternal mortality was among the highest in the world. After nearly two decades of political instability and war, a new government pledged to improve the country’s health outcomes by introducing a large-scale community health worker program—a robust, coordinated, government-led program integrated into the formal health system and designed to address the most pressing health challenges in rural Ethiopia.
From the onset, high-level political leadership aligned a coalition of support across ministries, geographies, donors, and NGOs.This concerted effort encouraged a multi-sectoral strategy, ensured financial backing, and allowed for rapid implementation that brought 35,000 community health workers and built 17,000 health posts in rural communities that had previously been unreachable. The government asked all NGOs to work with the government on this program under what they referred to as the ‘one plan, one budget, and one report’ model.
By 2010, five years after the introduction of the program, 94% of Ethiopia’s population had access to health services. The national program shifted the wider health system’s focus from treatment to prevention, improved coverage of prenatal care, contraceptives, and antibiotics for acute respiratory infections, and dramatically reduced under-five mortality.
Thanks to strong political will and national consensus, Ethiopia has succeeded in achieving most of the health-related Millennium Development Goals and cemented itself as one of the largest community health worker programs in the world.
While Ethiopia has dramatically improved health outcomes, challenges still remain around access to and quality of care, as well as low job satisfaction among community health workers. In line with Ethiopia’s commitment to monitor and refine the program to improve impact, the government is now focusing on strengthening community health worker performance by investing in their education, training, and management capacity.
Upon gaining independence in 1971, Bangladesh was one of the poorest and most densely populated countries in the world. It had among the lowest number of doctors and nurses per capita and its rural population had little access to healthcare. Bangladesh has made remarkable progress by investing in and refining their national community health worker program. The government has built community clinics and staffed them with community health workers, institutionalizing the role of community health workers and formally connecting thousands of rural villages with the national health system for the first time.
Critical to Bangladesh’s success has been the government’s decision to leverage NGOs to evaluate, innovate, adapt, expand, and improve programming to strengthen access to healthcare across the country. This partnership proved to be effective in helping the government subsidize the human and financial resources needed to deliver primary healthcare services to more than 100 million rural residents. Today, over 130,000 community health workers employed by both the government and NGOs work in a symbiotic partnership to deliver health education, preventive, promotive, and limited curative care across Bangladesh’s hard-to-reach regions. Together, the government and NGOs have expanded community health worker programming beyond its initial focus on family planning to address child health, maternal health, and universal healthcare.
This model, alongside significant investments in education, infrastructure and economic development, has enabled Bangladesh to achieve enormous advances in healthcare including some of the longest life expectancies, lowest total fertility rates, and lowest under-five mortality rates in South Asia. Though implementation challenges related to governance, human resources, and financing remain, Bangladesh has been able to dramatically improve access to health services for rural populations.
Our progress over the past year was made possible by the generous support of hundreds of partners like you who have invested in our shared vision of a health worker within reach of everyone, everywhere.
Fiscal Year 2019: July 1, 2018 to June 30, 2019.
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