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Despite high potential, many community health ventures in developing countries fail to evolve beyond the pilot stage. A fundamental problem is that many ventures utilize community health workers (CHWs) as volunteers, but they leave to generate a living income for their families. After ten years of experience running a community health venture in East Africa, while observing other ventures come and go, several factors have emerged as essential for any venture to achieve success. This article presents a methodology to set up a community health venture where CHWs generate income from their work while improving health outcomes for members of their communities. The authors seek to provide individuals working to solve last-mile healthcare challenges with a practical guide for establishing community health systems and navigating the validation, networking, planning, launch, and execution phases. The goal for the ventures developed using this methodology is to operate in an economically sustainable way.
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