Funder’s Learning Initiative February 21st, 2019

Community Health Systems Reach Vulnerable Communities … Because they are powered by them.

High Quality Community Health Systems Deliver Results Source: Rockefeller Foundation/WHO Source: 1 Million Community Health Worker Task Force Report

Community Health Systems Are Affordable and Integral to Primary Health Health Care Spending Per Capita – CHW Program Health Care Spending Per Capita – Total Spending CHW Program At Scale, % of Total Health Expenditure Ghana $2.10 USD $90 USD 2.3% Liberia $2.17 USD $112 USD 1.9% Malawi $2.93 USD $77 USD 3.8% Uganda $2.00 USD $128 USD 1.6%

The Path to National Scale is Challenging: Political Will + Frontline Focus on Quality, Affordability (1) Country Planning National CHW Taskforce Coordination Primary health care integration Political Support (3) Capability Mapping / Fleet Management Skill Map of Current CHW / Supervisors Mobile Infrastructure (2) Costing Investment Projections Refining Operational Assumptions (4) Coverage / Implementation Prioritization Partner Support Progress Indicators (5) Commodities / Diagnostics Work with Public Private Partnerships

They are United by a Focus on Equitable Universal Health Coverage A New Generation of “Radically Collaborative” Organizations is Emerging: They are United by a Focus on Equitable Universal Health Coverage Community Health Impact Coalition Financing Alliance AMP Health (management) African Union “2 Million Community Health Worker Campaign University of Global Health Equity (Rwanda) 4 billion people without access to health care, 1 billion in remote/rural areas

Are there big take away from countries that have achieved breakthroughs in life expectancy?… Source: Global Advantage Task Force Report

…Quality, Affordable Community Health Systems Enhance Equity + Effectiveness of Primary Health Care Source: Global Advantage Task Force Report

What’s next for Community Health Systems in America? Funders should recognize related parts/projects as part of a whole: Core support for Field-Building Research Centers (e.g. Penn Center) Core operating support for state-level community health roadmaps & identify practical integration w/primary health care (e.g. North Carolina) Support motivated community leaders and weave them into a larger network (e.g. RWJF culture of health leaders) Build a coalition of high-performing domestic community health organizations to surface practical challenges in quality implementation at scale Develop data-driven culture/platforms to support community health impact And recognize the rich history that guides action today: historic success of Community Health Centers & Community Organizers for Health.