In Lao People's Democratic Republic, the COVID-19 pandemic exacerbated existing health challenges, particularly among rural and marginalized communities. These communities grappled with limited healthcare access, vaccine hesitancy, sub-optimal maternal health outcomes, and limited trust in the health system. The issues were further compounded by insufficient local influence over healthcare decisions. In response, with support from the World Health Organization (WHO), the Lao PDR Ministry of Health and Ministry of Home Affairs launched the CONNECT initiative. This program sought to bridge the gap between rural communities and healthcare services, fostering trust, and cultivating local leadership in health. It brought measurable benefits to 185 communities across nine of 17 provinces in the country. The initiative facilitated improved relationships and governance, effective mapping of health issues, development of local problem-solving strategies, and enhanced local authority in health policy decisions. Vaccination rates have increased and anecdotal reports indicate rising trust levels, increased engagement with antenatal care, more childbirths happening at health facilities, enhanced coordination at village health centers, and a reduction in COVID-19 stigma.[1] These promising developments are now undergoing a formal evaluation process.

CONNECT initiative work has contributed to achieving 1) WHO-programme budget “Output 1.1.4: Countries’ health governance capacity strengthened for improved transparency, accountability, responsiveness and empowerment of communities” under “Outcome 1.1. Improved access to quality essential health services”; 2) Lao PDR-WHO Country Cooperation Strategy 2024-2028 "Strategic deliverable 1.3: Central role of governance sector in leading and sustaining health gains enhanced" under "Strategic priority 1: Promoting sustainable and resilient health systems toward universal health coverage”; and 3) "Outcome 3: Governance and Rule of Law" of UNSDCF. 

“After the CONNECT workshop, the village authorities and ethnic leaders really helped us by advocating to people in the community. The number of people using services each month in the health centre has almost doubled, and the most significant change is that delivery at home and child mortality has decreased significantly.”

- Lae Manivong, health centre director, Ban Bor Village, Bolikhamsai Province, Lao PDR

Conceived by WHO in collaboration with a selection of government entities in Lao People's Democratic Republic in 2021, the trailblazing CONNECT initiative seeks to promote collective problem-solving for enhanced community health, fueled by empowering local action. 

Backed by funding from entities such as the United States Agency for International Development (USAID), the European Union (EU), Luxembourg, the Korea Foundation for International Healthcare (KOFIH), and the Australian Government, the initiative has been hosting participatory workshops since 2021. [2] Workshop sessions engage a broad array of stakeholders, including representatives from communities, government agencies, healthcare facilities, and various ethnic and religious groups, promoting a multi-sectoral approach that extends beyond the confines of healthcare.

WHO provided technical support to develop training workshops that employ diverse activities, including role-play, scenario enactment, and community mapping exercises. These methods aim to identify key healthcare challenges and resources, with a particular emphasis on maternal, newborn, and child health during the COVID-19 crisis. WHO facilitators then lead sessions that encourage participants to devise solutions, with contributions sought from every segment of the village, focusing on those most reliant on essential healthcare services, such as expectant mothers and young children. This model fosters community trust empowers local communities - especially their most vulnerable members - and promotes a shift towards local governance in healthcare to strengthen the overall system.

Each workshop culminates in the creation of joint action plans that are displayed in community areas alongside maps and other relevant information, reflecting inputs from the entire village. In addition, the workshops establish WhatsApp coordination networks, empowering successful communities to guide their neighbors. This not only enhances trust but also strengthens relationships and governance.

– Mailor Xong, Hmong village chief, Ban Bor Village, Bolikhamsai Province, Lao PDR

To measure long-term impacts WHO devised a monitoring framework, and evaluation tools. Indicators include improved governance and health equity, community involvement, trust in healthcare providers, and increased uptake of essential maternal and child health services and local vaccinations. Navigating the common barriers of scalability and sustainability, CONNECT has skillfully utilized existing resources and successfully merged with government policies and procedures. Further driving the initiative, district governors, emboldened by the program, have pledged to facilitate its execution using local funds. WHO continues to provide ongoing technical support for training and monitoring.