Liberia took a proactive stance with donors. It did not merely accept donors’ plans but instead responded to funders’ offers with its own research and vision to maximize impact and fill critical gaps. As Liberia tracked and mapped each donor’s priorities, the country pushed less transparent donors to become more forthcoming about their own funding requirements. This approach proved remarkably successful. As of 2019, almost every major health sector development donor is funding some aspect of Liberia’s CHW program.

During the early planning phase, long before program launch, Liberia developed detailed financial costing and sustainability modeling that helped the government track and study three key variables: potential costs, potential benefits, and potential funding for each program. With these tools, Liberia could understand - at an extremely granular level - the costs and benefits of various elements of the program, as well as who might be willing to pay for them, and for how long. In addition, the government could identify financial gaps, both geographically and programmatically, match them with potential funders, and advocate for line-item resources, prioritizing specific items and geographic settings for further investments.

The country’s initial CHW program relied on volunteers in peri-urban areas. Evaluations of that program informed a 2012 CHW pilot program for rural areas with paid CHWs developed by the Ministry of Health and NGO partner Last Mile Health. Findings from the pilot showed significant improvements in access to health care for children and pregnant women. The pilot, which allowed the ministry to test and revise program elements, was eventually scaled nationally, with minimal changes, in 2016.