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In Kenya’s Kisumu County, Millicent Atieno begins her day as a community health promoter  with a sense of purpose. Armed with a toolkit, she embarks on her daily journey through the winding, dusty paths of Nyando Sub-County.

Millicent’s mission is profound: to bring healthcare to the doorsteps of those who need it most, especially women and children. But her work, while deeply rooted in tradition, is also at the cutting edge of modern healthcare innovation, thanks to the partnership between Living Goods and Amazon Web Services (AWS) through their Health Equity Initiative.

For years, community health workers (CHWs) like Millicent have been the backbone of primary healthcare in underserved regions. Their work is indispensable, yet they often face significant challenges—limited resources, inadequate training, and the daunting task of covering vast, remote areas.

But with the support of Living Goods and AWS, these challenges are being addressed in innovative ways, creating a ripple effect that is transforming the landscape of rural community healthcare.

Bridging the gap in primary healthcare

Living Goods, a nonprofit organization dedicated to improving health outcomes in underserved communities in Kenya, Uganda and Burkina Faso has long recognized the critical role of CHWs. By providing them with the tools, training, and support they need, Living Goods has been able to significantly impact maternal and child health in the regions where they operate.

Their approach is holistic, focusing not just on immediate healthcare needs but also on education, prevention, and the empowerment of local communities. They support governments – both national and sub national level- to professionalize community health workers and strengthen their community health systems, utilizing digital tools, equipping them with medicine and training, ensuring they are well supervised and adequately compensated to serve communities.

The partnership with AWS has brought a new dimension to Living Goods’ work. Through the Health Equity Initiative, AWS is helping to tackle some of the most persistent healthcare challenges in these communities. The initiative is focused on reducing disparities in healthcare access and outcomes, particularly for vulnerable populations. In the context of Living Goods’ mission, this means ensuring that CHWs like Millicent can reach even the most remote and marginalized individuals with the care they need.

In 2022, Living Goods Kenya was selected for the Amazon Web Services (AWS) Diagnostic Development Initiative, a global program focused on accelerating research and innovation to advance the collective understanding and detection of COVID-19 and other infectious diseases. This transcended further into their current work.

Kenya was selected for this pilot because its Ministry of Health (MoH) identified the enhancement of community-based disease surveillance (CBDS) as a key objective in its National Community Health Digitization Strategy 2020-2025.

The government selected Living Goods as the ideal partner for implementing this strategy, aiming to digitize and support all 95,000 community health workers (CHWs) across the country by 2025.

“We were thrilled to collaborate with AWS to advance our efforts to ensure CHWs are essential players in CBDS and can equip the government with the insights they need to effectively prevent and respond to health crises,” said Liz Jarman, CEO of Living Goods. “The COVID crisis underscored just how essential CHWs are both in preventing disease outbreak and ensuring an effective response, all while maintaining critical life-saving primary care services,” she said.

Through the $60 million (Sh7.7 billion) initiative, AWS provided Living Goods with computing credits and customized expertise from the professional services team. “We are proud to announce that, as of July 2024, we have fulfilled our 2021 pledge through the AWS Health Equity Initiative,” AWS said in a statement.  “As of June 2024, over 337 global customers have received credits to help change the landscape of health equity, bringing digital solutions to diverse communities and positively impacted over 109 million end users.”

Empowering community health workers

One of the ways Living Goods is enhancing community healthcare is by empowering CHWs with the knowledge and tools they need to be more effective in their roles. Training is at the core of this effort.

CHWs undergo comprehensive education not only in basic healthcare practices but also in specialized areas such as maternal and child health, infectious disease management, nutrition and family planning. This training is designed to be both practical and context-specific, ensuring that CHWs are equipped to handle the unique challenges of their communities.

For Millicent, the training has been transformative. “Previously, I knew how to take care of common illnesses, but I didn’t have the confidence or the knowledge to handle more complex cases,” she says during our sit down. “Now, I can identify signs of serious conditions early, provide advice on prevention, and even offer regular support.”

CHWs are also taught how to engage with their communities effectively, building trust and encouraging health-seeking behavior. This is particularly important in regions where traditional beliefs and mistrust of formal healthcare systems can be barriers to accessing care. By building strong relationships within the community, CHWs like Millicent can overcome these barriers and ensure that more people receive the care they need.

Innovating with essential tools

While training is essential, having the right tools is equally important. One of the most impactful innovations introduced through the partnership is the use of mobile technology to support CHWs in their work. Equipped with mobile devices, CHWs can now access a wealth of information and resources at their fingertips. This includes real-time guidance on diagnosing and treating common conditions, reminders for follow-up visits, and access to health education materials that can be shared with patients.

For Millicent, this has been a game-changer. “With my mobile device, I can quickly look up information if I’m unsure about a diagnosis or treatment. I can also keep track of the families I visit and make sure they get the follow-up care they need,” she explains. “It makes my work so much easier and more efficient.”

Building a stronger healthcare system

A critical area of focus has been maternal and child health. In many parts of Africa, maternal and child mortality rates remain unacceptably high, often due to a lack of access to timely and appropriate care. By empowering CHWs to provide antenatal care, support during childbirth, and postnatal care, Living Goods supports governments to address these challenges head-on.

Slava Odhiambo, a supervisor at Living Goods supporting Nyando Sub-County, has witnessed the impact of this approach firsthand. “We’ve seen a significant reduction in maternal and child mortality in the areas where Living Goods operates,” he says. “The CHWs are able to identify high-risk pregnancies early and ensure that mothers receive the care they need, whether it’s through home visits or referrals to health facilities.”

The initiative has also made a difference in the management of common illnesses. CHWs are trained to recognize the symptoms of diseases like malaria, respiratory infections like pneumonia and to provide appropriate treatment or referrals. This is crucial for early detection and intervention and in improving outcomes for those affected.

A government led, community-driven approach

At the heart of Living Goods’ work is a commitment to government-led, community-driven healthcare. This means not only providing services but also working with governments and communities to take charge of their own health and systems.

“The partnership between County and Living Goods was anchored on an MOU signed by both parties to work on a 70:30 ratio on implementation of the activities,” said Maureen Opiyo, Kisumu County, Community Health Coordinator. “Access to quality primary health care services is brought closer to the people and using preventive health to reduce disease burden and prevent severity of a disease.”

This approach is particularly evident in the way Living Goods works with the national government, county governments, local leaders and partners. By putting them in the center of the planning and implementation of health initiatives, Living Goods ensures that their efforts align with government priorities and are sustainable. This collaboration also helps to build trust and buy-in from the community, essential for long-term success.

 “Digital could be a game-changing enabler for the transformation of community health, and partnerships are key to unlocking its full potential. Our collaboration with AWS in Kenya and Uganda has been very effective in demonstrating the catalytic nature of digital solutions to enhance the effectiveness of community health workers and driving towards better health outcomes,” Living Goods said in a statement.

The company added that under the government leadership and guidance, the technology intervention has not only strengthened health systems but also ensured that life-saving services reach those who need them most. “This last mile impact has been the true success of this partnership.”

In Kisumu County, this approach has had a profound impact. “The community sees us as partners, not outsiders,” says Millicent. “They know we’re here to help, and they trust us. That makes a big difference in how they respond to our advice and the care we provide.”

As the world continues to grapple with issues of health inequality, the work being done by partners like Living Goods offers best practice on how to make meaningful change. It shows that with the right support, community health workers can be empowered to transform the health of their communities, one household at a time.

For Millicent Atieno and countless other CHWs, this partnership has been a lifeline, enabling them to do their jobs more effectively and with greater impact. And for the communities they serve, it has been nothing short of life changing.