Reaching Vulnerable Populations in Rural Areas: Liberia's National Community Health Assistant Program

With over 50% of Africans living in rural settings and 83% of the rural population living without basic healthcare coverage, there is a need for African countries to extend healthcare access to vulnerable people in remote areas. Many countries have addressed this issue by implementing community health programs centered around the work of community health workers, sometimes called community health assistants.

CHWs are healthcare providers who live in the community they serve and help to bridge the gap between rural populations and the formal healthcare system. Although they receive lower levels of formal education and training than professional healthcare workers such as nurses and doctors, they assume crucial health-promoting roles in the community. They help deliver diagnostic, treatment, or clinical care, encourage the uptake of health services, provide psychosocial support, and assist in disease surveillance.

In this episode, we look at Liberia's community health assistant program, a program forged in the wake of the Ebola virus epidemic between 2014 and 2016. The Liberian Government’s first attempt at CHW programming came with the 2008 National Policy and Strategy on Community Health Services. But the policy failed to meet its target due to fragmented implementation, lack of financial incentives for community health workers, and little standardized training and supervision. The new  National Community Health Assistant program, launched in 2016, was designed to expand healthcare access to rural areas by integrating community health workers into the national healthcare delivery scheme.

Guest: Ruston Yarnko, National Community Health Systems director at Last Mile Health in Liberia.

Additional resources

• What do we know about community health workers? A systematic review of existing reviews


• Community health worker programmes in the WHO African region Policy Brief


• Impact of the Liberian National Community Health Assistant Program on childhood illness care in Grand Bassa County, Liberia


• Community Health Workers in Liberia (Exemplars in Global Health)


• How Liberia’s frontline health workers are protecting us all