Fragile states are home over one-third of the world’s poor and areas of unusually high incidence of disease. With little to nonexistent state infrastructure and often a constant and evolving security threat, fragile states provide a unique challenge to health innovators.
CHMI profiles over 75 programs operating in fragile states. The majority of these programs (84%) focus on basic health services- primary care (25%), HIV/AIDS care (36%), maternal child health (28%)- fitting with USAID’s priority of addressing the most basic and pressing health problems in these countries. 16% of these programs focus on providing specialized services ranging from chronic disease care to mental health. The vast majority of these programs (over 60%) are private, not-for-profit entities. Roughly 11% are Public-Private Partnership and 8% are private, for profit entities. From training community healthcare workers to building the capacity of local government institutions and facilitating public-private partnerships, these programs are working to implement sustainable healthcare in areas where local healthcare institutions are nonexistent.
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In Malawi, government-supported community health workers—called health surveillance assistants (HSAs)—deliver a range of maternal, neonatal, and child health (MNCH) interventions in several community packages, each developed vertically and supported by a different department within the Ministry o