TY - JOUR T1 - Liberia's Community Health Assistant Program: Scale, Quality, and Resilience JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - S18 LP - S24 DO - 10.9745/GHSP-D-20-00509 VL - 9 IS - Supplement 1 AU - Jessica Healey AU - S. Olasford Wiah AU - Jannie M. Horace AU - Dianah B. Majekodunmi AU - Derry S. Duokie Y1 - 2021/03/15 UR - http://www.ghspjournal.org/content/9/Supplement_1/S18.abstract N2 - Key MessagesLiberia's national community health program went from dispersed pilots to nationwide scale within 4 years.A network of policy entrepreneurs from the Liberian government, donors, and implementing partners capitalized on several windows of opportunity to achieve this success.First, they seized the evidence from a series of pilot projects and—during a point of significant global momentum around community health—evaluated the agenda.Second, they leveraged the impact of the community health workers during the Ebola virus disease outbreak to propel forward a consolidated, paid cadre with significant political and financial backing.Policy makers and program managers should consider coalition building and identifying diverse champions as an essential ingredient for impacting large-scale change, even in the face of significant challenges.Liberia's community health program is bolstered by significant research and evidence. However, the policy entrepreneurs who brought the community leaders, Government of Liberia stakeholders, donors, and partners around the table to buy into a common program has been the “secret sauce” of the program's success.Libera has weathered significant financial, economic, and social hardship including over a decade of civil war and a year-long outbreak of Ebola virus disease (EVD). Over half of the country lives in poverty. The country's economic situation has been challenged by limited agricultural production and reliance on exports of raw materials, subject to global fluctuations in value. Given these challenges, how did Liberia transition from small-scale community health pilot programs to a government-led nationwide community health assistant (CHA) program in just 4 years?We argue that this success and the emergence of the community health program as a central pillar of Liberia's health strategy can be attributed to the convergence of ideas, interests, and institutions during significant windows of opportunity in Liberia. This catalytic and unifying change was driven by networks of “policy entrepreneurs”1,2 … ER -