Inspiring Health Equity at Global Health Day Event

Global Health Day 2018 Spotlights Leaders, Mentors, and New Research

“No condition is permanent,” said Dr. Raj Panjabi, CEO of Last Mile Health at the Global Health Day event on March 29, 2018 as he shared his vision of health equity that bridges the gap – the last mile – for reaching people who lack health care for treatable conditions.

Dr. Panjabi co-founded Last Mile Health in 2007 to build networks that bring access to healthcare to Liberia’s remote communities. The organization trains and empowers community health workers in local communities to use technology, build skills for basic diagnosis, and bring other lifesaving health services to people. In doing so, Last Mile Health has made it possible to resolve treatable conditions, such as malaria, pneumonia among children and care for hypertension, HIV and tuberculosis. Their work connects the dots in social, health and economic areas to improve the wellbeing of hundreds of thousands of people.  

Raj Panjabi presents on Last Mile Health to audiences for Center for Global Health's Global Heath Day event at Johns Hopkins School of Public Health on March 29, 2018. Photo credit: JHSPH

Raj Panjabi presents on Last Mile Health to audiences for Center for Global Health's Global Heath Day event at Johns Hopkins School of Public Health on March 29, 2018. Photo credit: JHSPH

The annual Global Health Day showcases knowledge, expertise and experiences in global health from the Johns Hopkins, local and international communities. Founded and led by Johns Hopkins Bloomberg School of Public Health's Center for Global Health, the day-long event was also co-sponsored by the MPH Program and the Alliance for a Healthier World (AHW). It featured Dr. Panjabi as keynote speaker, as well as mentorship awards for Johns Hopkins faculty, poster presentations showcasing student research and a photography contest. Like Last Mile Health, the AHW was established to address unresolved challenges in achieving health equity. AHW supports dynamic, multi-disciplinary collaboration among Johns Hopkins faculty, staff, students and external partners to support health and wellbeing for all.

Two of AHW Global Health Equity Scholars shared their perspectives below about Dr. Panjabi’s presentation on what it takes to drive positive impact to improve health equity.

Student Scholar Voices

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Amy McDonough

MPH/MBA Candidate, Carey Business School + Bloomberg School of Public Health + AHW Global Health Equity Scholar

In reflecting the tension global health organizations face between quickly scaling up and expanding versus strengthening their work where they have already succeeded, I was struck by a subtle yet essential distinction that Dr. Panjabi articulated in describing Last Mile Health’s mission. He described the difference between an organization “deepening and growing” and “deepening and leveraging.” The first approach can overemphasize scaling the organization and its brand, often at the expense of mission-aligned impact. By contrast, deepening and leveraging focuses on scaling the mission and impact, rather than the organization as an entity.

Last Mile Health is driven by this second type of thinking; its mission is to work with governments to implement community health worker programs, not to forward Last Mile Health as an organization. It is not seeking to expand to numerous countries in a few years, but rather carefully honing its model to achieve the greatest impact. After succeeding with their model in Liberia’s Konobo District, Dr. Panjabi deliberately decided not to seek grants and contracts from some of the largest global health funders, because doing so would have redirected their work toward organizational achievement. He also described how this mindset has helped support the development of the Community Health Academy, a global learning platform being created by Last Mile Health and their partners to reinvent education for hundreds of thousands of community health workers. The platform will be an open and shared resource, rather than credited to or owned by one organization.

Though the distinction Dr. Panjabi raised may appear simple, it is all too easy for us to be sidetracked with deepening and growing our organizations, especially as funding uncertainties increase. I was impressed by Last Mile Health’s organizational humility and targeted focus on its mission. Dr. Panjabi repeatedly noted that, “humans are not defined by the conditions we face, we are defined by how we respond.” As future leaders in charge of public health responses, this deepening and leveraging approach serves as an important model to ensure our focus remains on prioritizing strategies that will have the greatest impact on improving health equity.

Vinayak Bhardwaj

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MPH Candidate, Bloomberg School of Public Health + AHW Global Health Equity Scholar

“No condition is permanent,” Dr. Raj Panjabi intoned, invoking a mantra he had learnt from his father - first as a refugee fleeing civil war in Liberia and then as the leitmotif of his efforts to help with the post-war health system reconstruction in Liberia. He created Last Mile Health to provide care for those who too remote to be reached by most health outreach efforts. Its mission was buffeted as much by compelling data as it was by an abiding commitment to ensure the impermanence of disease and poverty for those most neglected by governments and NGOs. His efforts were validated when the country was ravaged by Ebola. Through the network of community care workers, doctors and policymakers that Last Mile Health had woven together, the epidemic was quickly brought under control, saving countless lives through simple, grassroots, day-to-day efforts at primary care and targeted assistance. Last Mile Health had found its global niche.

As Dr. Panjabi reflected not only on the organization’s successes but also on its failures, it struck me how important it was to integrate fully the experiences, wisdom and existing practices of the populations in which one’s interventions are targeted. While this is an oft-repeated dictum which all of us aim to be sincere towards, in reality, implementing it is hard. Dr. Panjabi described, for example, the importance of marrying a community health workers’ training program with a job creation strategy the Liberian government had developed, as a way to promote its popularity among top public officials whose job it was to implement them. While an acute understanding – and deep faith – in one’s intervention is needed, it is important to combine this with contextual knowledge in order to be effective. By promoting local ownership – often by recognizing how inter-related the needs of public health are to other societal issues – interventions are successful and often more sustainable. As an aspiring leader in global health, recognizing the importance of broader governance challenges while implementing targeted health policies was a key insight I learned from Dr. Panjabi’s ambitious, inspiring and resolutely humane approach.

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