Establish a network of Community Health Hubs (CHHs) — small clinics staffed by 2-3 trained community health workers (CHWs) backed by digital triage and telemedicine — positioned at the primary care layer as the default entry point for all non-emergency care. Design features: (1) Hub density: one hub per 5,000-10,000 people, covering 30-60 minute travel radius.

Cost $15K-30K to establish, $20K/year to operate including CHW salaries. (2) Digital triage backbone: Simple diagnostic algorithm on basic smartphone, trained on WHO guidelines for the 50 conditions responsible for 80% of preventable mortality in that region. AI-assisted diagnosis with built-in uncertainty flagging — if confidence below threshold, refer to telemedicine doctor.

(3) Task-shifted pharmacology: CHWs authorized to prescribe and dispense antibiotics, antiparasitics, and basic chronic disease medications within defined protocols — legal framework reform required but precedent exists (Nepal, Rwanda).

(4) Accountability loop: Monthly outcome data (treatment success, referral appropriateness, medicine stockouts) tied to CHW incentive payments and digital performance dashboards accessible to district health offices.