County Health
Living Goods Model: Strengthening Community Health Systems Through Performance Management and InnovativeTechnology
By Judy Sheri
Head of Community Strategy Dr. Salim Mohammed during a meeting with Living Goods in Busia
Community health workers( CHWs) have been called the“ world’ s most promising health workforce resource” in terms of enabling health systems in resource-constrained settings. Most often, CHWs— also referred to as community health volunteers( CHVs)— are relied upon to deliver a range of health services directly to communities and link households with the formal health system. Recently, there has been resurgence in global attention to CHVs, recognizing them as an integral part of the health workforce needed to achieve country health commitments.
In Kenya, a not for profit organization Living Goods is partnering with Busia County to implement a lowcost community health model focusing on several key areas that precipitate the majority of child deaths: community case management of childhood diseases, pregnancy support and newborn follow ups, nutrition counseling and prompt referral of cases to health facilities. The Living Goods model offers promising potential: an independent randomized control trial conducted in Uganda— where the organization began— revealed that it is achieving a 25 percent reduction in deaths of children under five. Through its partnership with the county government, Living Goods is strengthening CHV networks, building capacity, and positioning them to play a significant role in health care delivery. Ruth Ngechu, Director of Health at Living Goods, explains that the organization,“ help( s) mobilize resources and pass important health care skills into local hands through training— enabling communities to be better prepared to face adversity and be the first to respond effectively to an emergency.’’
Performance Management through Empowerment
The innovative Living Goods model provides performance-based income for CHVs. They don’ t work as volunteers or salaried staff; rather, they are empowered entrepreneurs who earn a small income by distributing impactful products and services in their community. The Living Goods model generates revenue that pays for the products, a retail margin that provides motivating incomes for the community health workers, and wholesale margins that cover some of the field distribution costs. Dr. Morris Siminyu, Chief Executive Officer for Health in Busia County, said that the county struggles to compensate CHVs and has thus encouraged them to explore income-generating activities that can help sustain their work. Living Goods presents an innovative hybrid model that can both deliver health impact as well as generate revenue for some operating costs.
Living Goods supports Busia County in providing three weeks of training, plus monthly in-service education— resulting in a well-trained, fully-equipped, and motivated team of community volunteers. CHVs are viewed as valuable and respected resources in their communities, and families know exactly who to go to for products and services. Because inventory is tracked electronically and restocked regularly, Living Goods branches and CHVs are always in stock on essential health
50 November-December 2016