Lao People's Democratic Republic

In Lao People’s Democratic Republic, SIMASHE is implementing a collaborative effort led by the Ministries of Health and Home Affairs to advance community trust for improved community health and well-being. The initiative uses the Community Network Engagement for Essential Health Care and COVID-19 Responses through Trust (CONNECT)  approach, integrating district-level dialogues, participatory village planning and health provider training to strengthen trust between communities and health systems, improve access to services, and identify local health and development priorities. Originally launched to address COVID-19-related barriers, CONNECT has since evolved into a broader strategy promoting health equity and community well-being. By March 2024, it had reached 217 villages across 60 districts in 10 provinces and the country’s capital, Vientiane. Evaluation findings show substantial improvements in trust, communication and service uptake – particularly among low-income groups and ethnically diverse populations that are difficult to access. Antenatal care attendance, vaccination coverage and use of birth services have all increased, while innovative communication methods and inclusive outreach have addressed language, cultural and disability-related barriers. Sustainable financing mechanisms are in place, with provinces now scaling up the approach using their own budgets. 

Country achievement highlights

1. Political attention from the COVID-19 pandemic was leveraged to address health governance and local ownership of primary health care.
   
2. A Memorandum of Understanding between the Ministries of Home Affairs and Health provided the political and administrative mandate to strengthen local health governance under the ”three build” policy whereby responsibility is increasingly devolved to local administration levels (province, district and village).
   
3. A comprehensive primary health care approach was developed, field-tested and endorsed for nationwide rollout, to strengthen local governance and community engagement.
   

Main activities 2025–2028

• The specific focus of Lao People’s Democratic Republic during this time will be to share with neighbouring countries lessons from institutionalization and ongoing use of the approach, , and in and through the SDH Initiative.
• Various documents will be developed to describe the Lao People’s Democratic Republic CONNECT experience. During Phase I of the SDH Special Initiative, the country undertook in-depth evaluations that provided highly nuanced understanding of the role of trust in improving service demand.
• The country will host and engage in intraregional and interregional knowledge exchanges, webinar events meetings and workshops to share lessons from CONNECT and learn from other stakeholders. This includes contribution of case studies to the Special Issue of the “International Journal for Equity in Health”.
• Further exploration within Public policy areas on how to connect the capacity-building work on social protection in the region – e.g. with the International Labour Organization (ILO) – and globally – e.g. with ILO and on the Second World  Summit for Social Development– to support the sustainability of CONNECT in Lao People’s Democratic Republic, as well as broader work to address health equity. Discussions are underway with the ILO to support the development of community-level information products on access to social security policies and entitlements, to further enhance community engagement for addressing the social determinants of health equity.