Integrating Community Health Program

A community health worker examines a patient in Kita, Mali
A community health worker examines a patient in Kita, Mali
Photo credit: Jane Silcock/USAID


The Integrating Community Health Program (ICH) is a collaboration between the U.S. Agency for International Development (USAID) and UNICEF that will support countries to achieve and sustain effective coverage of proven health interventions at scale and contribute to ending preventable child and maternal deaths.

A collection of seven awards, ICH is designed to strengthen the role of community health approaches to reduce barriers to health coverage and support national policies and implementation plans. USAID will invest over $9 million in these awards, which in turn will leverage an additional $10 million in investments from other sources, as well as support in the form of trainings, equipment, and direct support to community health workers. 

The seven awards will work in USAID’s ending preventable child and maternal death priority countries across Africa, South Asia, and the Caribbean.


Save the Children:

In Bangladesh, there is no national policy or associated strategic direction for the use of CHWs. This award will support the Ministry of Health to initiate policy updates to be incorporated in the 2016–2021 health sector program. The reforms will contribute to improvements in CHW programs across the multiple dimensions below:

  • Optimal utilization of CHW potential
  • Increased efficiency of CHW programming
  • Improved supportive environment for CHWs through broader and deeper community engagement

National strategies and guidelines for community engagement and CHW programs will be informed by district learning labs (DLLs). The DLLs will focus on the feasibility and effectiveness of CHW approaches and will showcase the success of innovations.

Democratic Republic of Congo

Humana People to People Congo (HPP-Congo):

HPP-Congo proposes to build up the Community Health Worker (CHW) system by developing models of community mobilization in support of CHWs in Kasenga, Selembao, and Kingabwa municipalities. The project will harness the use of networks, stakeholders, and local staff, including strong working relationships with the Ministry of Health and the Scaling Up Nutrition network, to develop catalytic and replicable approaches to strengthen community-level support for CHWs and enhance the voice of underserved communities. HPP-Congo will:

  • Mobilize community members by training them to be health activists
  • Encourage youth clubs to engage with other youth in nearby communities
  • Improve motivation and build capacity of existing health staff
  • Reduce barriers to effective coverage
  • Increase buy-in from key stakeholders and strengthen stakeholder engagement
  • Improve and synergize programming across networks


Zanmi Lasante:

Zanmi Lasante will work to strengthen a unified, new structure for a cadre of community health workers in the Mirebalais commune of Haiti’s Central Plateau. The project will work to achieve and sustain effective coverage of the essential package of health services and will serve as a model for national scale-up.

This project aims for the CHWs to be directly linked to the health system through a systematic training and certification process, a coordinated referral system, a supportive supervision system, and improved health information systems. This systems approach is designed to have a catalytic effect, positioning the Ministry of Health to coordinate its implementing partners and harmonize existing, fragmented CHW programs into one unified structure, integrated within the health system to provide comprehensive healthcare to communities across the country.


Liverpool School of Tropical Medicine (LSTM):

LSTM will work to increase community-level access to and facility-level utilization of high-quality maternal, newborn, and child health services. LSTM will work across multiple levels and sectors to support this goal. LSTM will:

  • Strengthen leadership and coordination at national, county, and community levels, embedding a culture of quality improvement practice at each level
  • Emphasize capacity building and community engagement
  • Focus on quality improvement in community health worker programming to improve equity and social accountability
  • Implement a community scorecard to help communities develop a health action plan and increase accountability
  • Build the capacity of county decision makers to prioritize and budget for programs using equity approaches


Last Mile Health (LMH):

LMH will support the Government of Liberia to launch and scale a national community health worker program. The CHW program will recruit, train, and deploy approximately 4,100 CHWs and 230 clinical supervisors over the course of the next 7 years, transforming a currently fragmented community health volunteer program into a rigorous national CHW program that extends basic primary services to communities further than 5 kilometers from a health facility.

In line with the President’s strong political commitment to building women-led capacity to reach the most vulnerable at the community level, LMH will assist at all stages of the CHW program’s design and implementation. LMH will:

  • Jointly design and plan for the establishment and roll out of a national CHW program
  • Identify, mobilize, and leverage the funding necessary to support a national CHW program
  • Support the MOH to bring about measurable reductions of morbidity and mortality in remote communities in Liberia through joint implementation


Aga Khan Foundation (AKF):

AKF will work with key organizations at the national level in Mali to support the institutionalization, implementation, and scale-up of the Ministry of Health’s (MOH’s) “Basic Community Healthcare Strategy” (BCHS) to reduce maternal, newborn, and child mortality in Mali.

In support of the BCHS, the AKF project will strengthen community engagement and the use of data to make community health worker (CHW) programs more responsive to community needs. This project will:

  • Increase demand for, access to, and use of high-impact community health services set forth in the BCHS, including the services provided by CHWs
  • Build the capacity of local community-based organizations for governance and management and ensure that resources are available to support the work of the CHW
  • Strengthen monitoring, evaluation, and data systems by developing and promoting a mobile data collection and alert system for CHWs, allowing them to report information and receive automated prevention and treatment messages

To ensure the project has a catalytic effect and long-lasting impact, it will focus on fully integrating and strengthening community-level healthcare into the national health system.


Pathfinder International:

Pathfinder will focus on an integrated systems strengthening model to address barriers faced by village health teams. The project will build the capacity of community health extension workers (CHEWs) at community, district, and national levels. Toward this end, it will:

  • Integrate family planning with maternal, newborn, and child health interventions at the community level in two districts of Uganda
  • Inform the national rollout of revised CHEW policy and support the Ministry of Health to establish a new cadre of CHEWs that will be integrated into the health system
  • Strengthen partnerships between communities and systems through co-management committees and consortiums at the national and local levels to ensure sustainability
  • In collaboration with stakeholders, advise, assist, and build the capacity of the MOH for national influence and impact
  • Assist district governments in health program planning, budgeting, supervision, and data use for decision making
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