Serving the world’s hardest to reach

Frontline health care at UBS Optimus Foundation

Meet Integrate Health, a UBS Optimus Foundation partner in Togo

Community health workers and primary health care facilities are central to ensuring the most vulnerable get care – both go hand in hand.

Integrate Health saves lives in the world’s most neglected communities by integrating professional community health workers with improved care in public clinics. This powerful combination transforms the poorest-performing government clinics into lifesaving centers of excellence. Integrate Health currently serves close to 100,000 people through several health centers across Togo. Over three years, they've observed a 50 percent reduction in child mortality in the pilot communities where Integrate Health works. Building on this success, Integrate Health is expanding to serve more people and scale the model nationally.

The problem you'll help to address 

The lack of access to health care services has far reaching consequences.

Half of the world’s 7.3 billion people lack access to essential health services.1

303,000 women worldwide died due to maternal causes in 2015.2

5.4 million children under 5 died from preventable causes in 2017.3

2.5 million of these deaths were newborns in their first month of life.4

An additional 1 million children aged 5–14 died from preventable causes.5

75% neonatal deaths due to prematurity, intrapartum-related events or neonatal sepsis.6

Acute respiratory infections, diarrhea, and malaria are the leading causes of death among children aged 1–59 months.7

Undernutrition is linked to 60% of all deaths of children under age 5.8

Bring a health worker within reach of everyone, everywhere. Impossible? Last Mile Health, our UBS Optimus Foundation partner, is on a mission to reach the most remote communities.

In Liberia, a front line of the Ebola-outbreak, people's chances of getting lifesaving or preventive life care decrease based on the distance they live from a care facility. If you're a two year old, and you come down with a fever, your mom would have to put you on her back get to the river bed, get in a canoe, paddle across the other side and walk for up to two days just to get a diagnosis in a clinic.

Children still die at 20 times greater rates in remote and underserved countries such as Liberia than in Switzerland, the UK, the US or Hong Kong. Last Mile Health, since 2013, is on a mission to change this by ensuring that well-trained community health workers reach even the most remote communities.

Watch the video to experience life in remote Liberia.

Underlying causes of child and maternal deaths

Geographic distance

One billion people live in remote areas without easy access to health facilities.9

Financial

100 million people are pushed into extreme poverty each year due to out-of-pocket health expenses.10

Human resources

  • Massive shortage of health care workers forecast to grow to 18 million by 2030.11
  • More than 40 percent of all pregnant women do not receive adequate antenatal care.12
  • Nearly half of all births in low-income countries occur without a skilled birth attendant.13
  • More than half of mothers and babies have no postnatal contact with providers who can deliver interventions that save lives.14

Infrastructure

50 - 70 percent of rural health centers lack access to reliable electricity and water.15

Gender norms

Restrict women’s movement and decision-making power, including with respect to their families’ use of health services.

Meet Doris, a community health worker at Last Mile Health, one of our UBS Optimus Foundation partner

Strong frontline healthcare:

  • Is associated with longer life expectancy and lower infant and under-five mortality
  • Can meet 80 percent of all health needs
  • Supports equitable distribution of health
  • Serves as an early warning mechanism to detect and respond to disease outbreaks
  • Is key to addressing the growing burden of non-communicable diseases in developing countries

We can help you maximize your philanthropy in the area of frontline health care by focusing on three strategic areas.

Strategic focus areas

Method

Target output

Expand community health workforce and improve primary health center quality

  • Validate and replicate capacity building models for community health workers
  • Invest in facility-based interventions to improve quality
  • Validate and replicate models to improve referral pathways

 

 

  • # CHWs trained and deployed
  • % population with access to quality health services
  • # primary health centers with improved standard of care
  • Improved range of services

 

Increase efficiency and promote data-driven decision-making

  • Validate and scale digital health tools that improve performance of frontline health workers
  • Invest in developing 'off the shelf' digital tools to facilitate replication

  • # digital health tools validated and replicated
  • Increased and improved evidence base

Support innovative financing to improve delivery of health services

  • Design, test, and scale new mechanisms of sustainable financing
  • Promote results-based financing

  • # social entrepreneurs identified and supported
  • # pilots of new financing and delivery mechanisms

More effective together: Collaborating for improved community health

Living Goods supports official government health workers, empowering them as entrepreneurs by paying for performance from the retail margin on its health products, plus small impact-tied incentives. Because the business model recovers 100 percent of the cost of the products and generates margin to pay the health workers, the remaining yearly cost is less than USD 2 per person.

Living Goods and Last Mile Health, another UBS Optimus Foundation partner, both share a vision: to transform community health in the world’s hardest to reach places. By collaborating together, they aim to galvanize thousands of digitally empowered community health workers providing on-call home health care to over millions of people in Africa.

We talked to Chuck Slaughter the Founder of Living Goods about the importance of collaboration and mobile technology to transform community health on a game-changing scale. Here's what he had to say

Living Goods and Last Mile Health share a common vision to leverage mobile technology to transform community health on a game-changing scale. But we are also complementary leaders.

I have experience in building successful businesses from scratch. Raj Panjabi, co-founder and CEO of Last Mile Health, is a medical doctor and adept at partnering with governments. Living Goods is strong in East Africa, while Raj has had success in West Africa. Both our organizations share the same core methods, but we employ multiple approaches to managing and scaling networks. Having more than one path to scale increases the odds of achieving national impact in diverse countries, since local policies and economics
vary widely.

We deliberately seek to partner with individuals and organizations that can bring expertise and networks. The UBS Optimus Foundation and philanthropists’ know-how and connections increase the odds that we deliver success at scale. Our achievements to date have been driven by smart, flexible funding that came mostly from successful entrepreneurs and investors. This unrestricted funding allows Living Goods to
test new ideas quickly (and walk away from experiments that are not working).

We need partnerships that bring together the very best practices from both the private and public sector. From the private sector we need speed, innovation, and accountable performance management. From the public sector we need the reach, policy power, and political will to move the UN Sustainable Development Goal agenda forward. And, importantly, we need innovative financial partnerships that use financial resources most effectively while deftly minimizing risks. These funding innovations span the range from results-based financing, through impact bonds and insurance to matching mechanisms. We’ve learned several important lessons from collaborating with others:

  • Seek partners who are strong where you are not, and build your collaboration to leverage your comparative strengths.
  • Bring an open, inquiring mind-set to every partnership. You always have something to learn from your partners.
  • There is no limit to what you can accomplish when you give credit to others (I find this wisdom applies equally well to marriage and parenting!).”

Meet We Care Solar

Each year, over a quarter of a million mothers die of pregnancy-related complications and nearly one million babies die on the first day of their life, often in health centers without reliable electricity. 

The Solar Suitcase is low cost and easy to use and captures the sun’s energy during the day to provide a reliable source of electricity at night in health clinics in poor rural areas. This powers lights and medical and communication equipment, transforming the chances of survival for mothers and babies.

1 WHO (2017). World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses. Retrieved from: https://www.who.int/news/item/13-12-2017-world-bank-and-who-half-the-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses#:~:text=At%20least%20half%20of%20the,the%20World%20Bank%20and%20WHO.&text=Currently%2C%20800%20million%20people%20spend,child%20or%20other%20family%20member. Last consulted: October 28, 2020.

2 WHO (2015). Maternal health: Death during pregnancy and childbirth. Retrieved from: https://www.who.int/news-room/q-a-detail/maternal-health-death-during-pregnancy-and-childbirth. Last consulted: October 28, 2020.

3 WHO (2020). Children: improving survival and well-being. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality. Last consulted: October 28, 2020.

4 WHO (2020). Newborns: improving survival and well-being. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Last consulted: October 28, 2020.

5 WHO (2020). Children: improving survival and well-being. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality. Last consulted: October 28, 2020.

6 WHO (2020). Newborns: improving survival and well-being. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Last consulted: October 28, 2020.

7 WHO (2020). Children: improving survival and well-being. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality. Last consulted: October 28, 2020.

8 WHO (2000). Bulletin of the World Health Organization, 2000, 78 (10).

9 WHO (2010). Increasing access to health workers in remote and rural areas through improved retention: Global Policy Recommendations. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/44369/9789241564014_eng.pdf. Last consulted: November 10, 2020.

10 WHO (2017). Tracking universal health coverage : 2017 global monitoring report. Retrieved from: http://documents1.worldbank.org/curated/en/640121513095868125/pdf/122029-WP-REVISED-PUBLIC.pdf. Last consulted: October 30, 2020.

11 WHO (2016). Working for health and growth: investing in the health workforce—report of the High-Level Commission on Health Employment and Economic Growth. 2016. Retrieved from: http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf. Last consulted: October 30, 2020.

12 UNICEF (2020). Antenatal care. Retrieved from: https://data.unicef.org/topic/maternal-health/antenatal-care/. Last consulted: October 30, 2020.

13 WHO (2017). Global Health Observatory Data: Skilled attendants at birth Situation and trends. Retrieved from: https://www.who.int/gho/maternal_health/skilled_care/skilled_birth_attendance_text/en/. Last consulted: October 30, 2020.

14 WHO (2017). Global Health Observatory Data: Skilled attendants at birth Situation and trends. Retrieved from: https://www.who.int/gho/maternal_health/skilled_care/skilled_birth_attendance_text/en/. Last consulted: October 30, 2020.

15 UN Foundation, SEforALL (2019): Lasting impact – Sustainable off-grid solar delivery models to power health and education. Retrieved from: http://poweringhc.org/wp-content/uploads/2019/04/Lasting-Impact_Sustainable-Off-Grid-Solar-Delivery-Models-to-Power-Health-and-Education.pdf. Last consulted: October 30, 2020.

16 PHCPI (2018). Why Primary Healthcare? Retrieved from: https://improvingphc.org/why-primary-health-care. Last consulted: November 10, 2020.

17 WHO (2019). Maternal mortality: Key Facts. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality. Last consulted: November 2, 2020.