Last Mile Health: Securing Funding to Scale Community Health Systems

Last Mile Health is ensuring access to health services in rural areas in Africa by supporting and advocating for professional community health workers.

Discover the funding model that supports their scaling efforts and explore the key factors driving their financial success.

Situation

  • Problem: Half of the world’s population—including a billion people living in remote communities—lack healthcare access, mainly due to distance.
  • Solution: Partner with governments to build community health systems, with professionalised community health workers in rural and remote areas.
  • Impact: Supporting over 17,000 health workers, reaching 20 million people in rural Ethiopia, Liberia, Malawi, and Sierra Leone with primary care.
  • Annual Budget: $27.3 million.

 

Funding model at scale

Last Mile Health is working to close the health access gap by equipping community health workers to provide essential services in remote rural areas of Ethiopia, Liberia, Malawi, and Sierra Leone.

How do they do it?

Last Mile Health works within government health systems, aligning with existing community health worker programmes, integrating community health workers into national supply chains and data systems, and standardising training and supervision. By doing so, they embed new approaches within government structures.

A key focus of their strategy is advocating for fair pay and the professionalisation of community health workers, who are often treated as unpaid volunteers. These workers face challenging conditions, leading to high turnover and inconsistent service. Last Mile Health leverages their evidence and partnerships to encourage governments to provide adequate recruitment, training, supplies, supervision, and salaries, ultimately improving health outcomes.

They also provide technical support to Health Ministries, helping build community health systems and policy expertise. While Last Mile Health plays a significant ongoing support role to Ministries of Health, it receives no direct government funding; 80% of its budget is covered by philanthropy and 20% by institutional funding.

“I don’t lean into the idea that each institution needs to have a unique value proposition. Due to the scale of the problem that we’re trying to solve, we need a community of committed and supported practitioners and implementers, rather than to develop a never-seen-before programme” –  Lisha McCormick, CEO

I don’t lean into the idea that each institution needs to have a unique value proposition.

Lisha McCormick Chief Executive Officer

Adopting a scaling mindset

Last Mile Health embraced a “learner’s mindset”, staying open to any solution that delivered patient care. This adaptability allowed them to stay open to different approaches without needing to be uniquely differentiated and pursue the most impactful paths. They also prioritised autonomy, only accepting funding aligned with their mission of improving community health systems, even if it meant turning down other potential revenue sources.

“During the Ebola crisis, we were asked to administer the supply chain. We had to take a step back and clarify ‘what are we really good at’. Despite there being funding attached to it, that was not an area where we had the unique capability and capacity to yield the greatest value, and other institutions probably did.

We turned down the opportunity so that our staff could focus on what we are really good at”- Lisha McCormick, Chief Executive Officer

Key success factors for securing funding for scale

  1.    Demonstrating impact and credibility

Last Mile Health was able to secure funding for community health systems from early-stage impact investors like Draper Richards Kaplan and Mulago because they were able to demonstrate that their community health worker model was achieving tangible results, such as dramatic improvements in immunisation rates and facility-based deliveries.

  1.   Building a trusted partnership reputation

Over time, Last Mile Health built a reputation as a trusted and valued partner by “doing what they said they were going to do”. This track record of delivering on their commitments helped establish trust with funders, which helped them secure larger, more competitive funding from multilateral and bilateral donors like USAID and the Global Fund.

  1.   Diversification of funding sources

By intentionally retaining a mix of funding sources, particularly flexible philanthropic capital, Last Mile Health preserved its autonomy to follow its strategic goals rather than being tied to any single funder’s agenda.

Get funding ready

Securing Nonprofit Funding Report

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