Background: Partners In Health (PIH) committed to improving health care delivery in Maryland County, Liberia following the Ebola epidemic by employing 71 community health workers (CHWs) to provide treatment support to tuberculosis (TB), HIV and leprosy patients. PIH simultaneously deployed a socioeconomic assistance program with three core components: transportation reimbursement to clinics; food support; and additional social assistance in select cases.Objective: This study aimed to evaluate how a CHW program for community treatment support and addressing socioeconomic barriers to care can impact patient outcomes in a post-conflict and post-epidemic context. Methods: Retrospective observational study utilizing registry data from 513 TB, 447 HIV and 75 leprosy patients at three health facilities in Maryland County, Liberia. Treatment coverage and clinical outcomes for patient cohorts enrolled in the pre-intervention period (January 2015 to June 2015) and the post-intervention period (July 2015 to July 2017) are compared using logistic regression analyses. Results: TB treatment coverage increased from 7.7% pre-intervention to 43.2% (p < 0.001) post-intervention and lost to follow-up (LTFU) rates decreased from 9.5% to 2.1% (p = 0.003). ART treatment coverage increased 3.8 percentage points (p = 0.03), with patient retention improving 63.9% to 86.1% (p < 0.001); a 6.0 percentage point decrease in HIV LTFU was also observed (p = 0.21). Despite an 84.3% treatment success rate observed for leprosy patients, pre-intervention data was largely unavailable and statistical significance could not be reached for any treatment outcomes pre-post intervention. Conclusions: The PIH approach to CHW community treatment support in Liberia demonstrates how, with the right inputs, excellent clinical outcomes are possible even in postconflict and post-epidemic contexts. Care should be taken to position and support CHWs so that they have the opportunity to succeed, including full integration and recognition within the system, and the addition of clinical system improvements and social supports that are too often dismissed as unsustainable.

Assigning community health workers to households, as opposed to individuals, is a feasible and functional method for structuring how community health can contribute to implementing universal health coverage.

In challenging environments, LTFU can be reduced by CHW accompaniment and socio-economic assistance to patients with TB. Approaches are needed to improve cure verification in young patients and reduce mortality.

Unfortunately, the number of students trained by new, Haitian instructors was capped at 12 due to space limitations. Concurrently, MS4H certified 39 Haitian medical students new to BLS. Mean BLS certification-exam scores of students taught by Haitian peers and those taught by MS4H were compared using an unpaired t-test.Original Data and Results: Haitian-taught students' mean scores were 90.0% (SD ¼ 10%), compared to 87.6% (SD ¼ 11%) for MS4H-taught students. Of those taught by Haitian peers, two students (16.7%) required remediation compared to 9 students (23.1%) who were taught by MS4H. An unpaired t-test yielded no significant differences between the two groups' scores (p ¼ 0.67). Conclusion:Our results demonstrate that a "Training the Trainers" model, where Haitian medical students are trained as BLS instructors, may be feasible and equivalent to BLS training by American medical students and residents trained as BLS instructors. In future years, larger scale studies need to be done to validate this small pilot study. If validated, this teaching method can advance further sustainable BLS teaching programs at Université Quisqueya and other medical centers in Haiti.