Consultant, National Community Health Worker Strategy

This role was posted on May 12, 2025. Please note that we will review applications on a rolling basis. Please apply by May 19, 2025

The Role

At Last Mile Health, we make bold commitments that inspire innovation. Do you have experience leading national-level health policy or strategy development processes, ideally in collaboration with government, and a strong understanding of community health programs, especially in Sub-Saharan African contexts? If so, you may be the perfect fit for the National Community Health Worker Strategy Consultancy.

In 2021, the Ministry of Health (MOH) in Sierra Leone revised its Community Health Worker (CHW) Policy and Strategy to guide implementation through 2025. Since then, Last Mile Health (LMH) has worked side-by-side with the MOH to strengthen a more effective, equitable, and data-driven community health workforce. 

As the current Strategy period concludes (2021-2025), LMH is supporting the MOH with a strategic review of the community health worker program to assess progress, identify challenges, and shape the vision of community health in Sierra Leone. 

This consultancy will support this effort by leading a visioning process with the MOH to assess the quality and performance of the current CHW program and co-develop a roadmap for the CHW Strategy for the next 5 years and a long-term vision. The objectives of the consultancy are to: 

• Review the implementation of the 2021-2025 CHW Policy and update the Program Quality Improvement Plan. 
• Facilitate the strategic visioning and alignment with the MOH on the future direction of the CHW program. 
• Lead the co-creation of a roadmap to inform revisions to CHW strategy and policy, grounded in evidence, stakeholder input, and long-term sustainability. 

This consultancy is available to candidates who are located in and authorized to work in Sierra Leone.

Consultancy Details

• Total Estimated Fees Amount - $18,000
• Location - Sierra Leone (in-person work arrangement)
• Duration: May 26, 2025 - September 30, 2025

Background and Context

Sierra Leone is implementing an integrated NCHWP policy and strategy. There are ~8,000 CHWs trained and deployed across all 16 districts, providing community-led health services. Although Sierra Leone’s CHW program is nascent, the Ministry of Health (MOH) and partners have invested significantly in the NCHWP to strengthen health systems to facilitate quality community health services. 

Since 2012, CHWs have been involved in the delivery of community health interventions guided by the 2012 and 2016 policies. Implementation was markedly fragmented, with different partners and disease programs managing different sets of CHWs across the country.  In 2021, following an assessment of the NCHWP, the policy was revised to integrate TB, HIV, and Malaria CHWs into the NCHWP. Partners continue to provide MOH, through the CHW Hub, needed resources and technical assistance to strengthen implementation at national and district levels, whilst community health services are delivered by CHWs, focusing mainly on iCCM, RMNCAH, surveillance, and health promotion activities.  

About Building Integrated Readiness for Community Health (BIRCH)

Global Fund, through different funding mechanisms, including project BIRCH, is the primary donor supporting the NCHWP. Project BIRCH aims to strengthen community health programming in eleven countries, including Sierra Leone, through Technical Assistance in health financing, operational planning, and stakeholder coordination. Following a community health system maturity assessment by key stakeholders within the health sector, gaps and key program priorities were identified and translated into activities, in alignment with the required Global Fund foundational elements for BIRCH support in 2024 and 2025.  

The MOH recommended Last Mile Health as the Implementing Partner to the BIRCH project in Sierra Leone. Global Fund has therefore contracted Last Mile Health, through Africa Frontline First (AFF), to manage BIRCH funds and to work closely with the CHW Hub and partners to strengthen the NCHWP and establish the required building blocks to mature the NCHWP for sustainability. In January 2024, a costed workplan detailing all deliverables and activities for BIRCH support was developed and has been approved by AFF and the Global Fund for implementation. 

Scope of Work

The following scope of work describes the key tasks to be accomplished through this consultancy (subject to change depending on timing and external events).

TASK 1

Stakeholder Consultation Report on discussions around the MOH’s long-term vision

1. Establishment and coordination of a technical steering committee, in collaboration with the Directorate of Primary Health Care and the CHW Hub, to guide the CHW program review process.
2. Facilitation of meetings with the steering committee to articulate a shared 10-year vision for the Community Health Worker (CHW) program.
3. Develop and validate a 10-year strategic vision for the future of community health in Sierra Leone.
4. Translate the agreed-upon vision into a set of strategic SMART (Specific, Measurable, Achievable, Relevant, Time-bound) objectives as the basis of a new CHW Strategy 
5. Present the proposed vision and strategic objectives to high-level, interministerial stakeholders, securing alignment and buy-in.
6. Submit a Stakeholder Consultation Report with the validated MOH’s long-term vision for the CHW program. 

TASK 2

Program Assessment and Gap Analysis

1. Submit a comprehensive gap analysis comparing the current implementation of the CHW program with the newly defined 10-year vision, identifying key areas for improvement and alignment.
2. In reviewing the Quality Improvement Plan, consult the EGH research data, 2024 maturity assessment report, other program assessment reports, CHIS data, 2024 supervision data, and the 2025 operational plan to understand the gaps and how they will be addressed in the strategy

TASK 3

Policy Addendums, Identification, and Policy Revision Roadmap

1. Identify and propose Policy Areas of review and potential addendums to the existing CHW Policy 2021 - ie, service delivery package, recruitment process, training process, and content - based on the validated Program Vision and CHW strategy (2026-2031).
2. Draft a roadmap report outlining timelines, strategic priorities, and implementation recommendations for policy revision and program evolution in line with the 10-year strategic vision for the program. The report will include the following sections: Vision Statement, Gap Analyses, Collectively identified Next Steps, and Addendums with the list of proposed changes, including but not limited to the service package. 
3. Present the proposed road map to the steering committee and high-level, interministerial stakeholders to ensure alignment and buy-in.

What you’ll bring:

• Master's degree in public health, health management, behavioral sciences, organization strengthening, or equivalent, or recognized and long experience in supporting the health sector.
• Progressive years of professional experience related to optimization in health care, and design of health systems. 
• Demonstrated years of experience working with Global Fund financing, including experience working with civil society.
• Progressive experience in health systems strengthening, with a specific experience in community health, policy development, and strategic planning. 
• Demonstrated experience leading national-level health policy or strategy development processes, ideally in collaboration with government. 
• Strong understanding of community health programs, especially in Sub-Saharan African contexts, with strong experience of Sierra Leone’s Community Health System.  Proven ability to facilitate high-level stakeholder engagement and consensus-building processes. 

You’ll impress us if

• You can work independently, manage multiple workstreams, and deliver high-quality outputs promptly.
• You have experience conducting program reviews, gap analyses, and translating findings into policy recommendations.
• You have Experience in community health advocacy

About Last Mile Health

Last Mile Health (LMH) saves lives in the world's most remote communities by partnering with governments to bring critical primary care services to the doorsteps of people living in the last mile. LMH is a registered 501(c)3 non-profit organization and currently works in Ethiopia, Ghana, Liberia, Malawi, Ethiopia, Uganda, and Sierra Leone with US offices in Boston. For more information, visit www.lastmilehealth.org. 

We are an equal-opportunity employer and value diversity at LMH. We do not discriminate on the basis of race, religion, colour, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.