Site of the organization: World Health Organisation
Type of publication: Report
Date of publication: 2022
The health of a nation is a critical indicator of its overall well-being and progress. Recognizing the importance of a robust and sustainable health system for the well-being of its citizens, the Government of Liberia, with support from WHO and partner agencies, has made significant efforts, even during major events, such as the upcoming election in October 2023 and the outcome of the concluded National Census in January 2023. This annual report provides an overview of these efforts and the progress made in building Liberia’s health system over the past year. The sections in this report highlight the achievements, challenges, and opportunities in the development of the health system, with a focus on the key initiatives and programmes implemented and supported by the four clusters in the Liberia Country Office from January to December 2022 to improve access to quality healthcare through UHC. These are:
(i) Universal Health Coverage-Life Course,
(ii) Health Emergencies,
(iii) Universal Health Coverage-Communicable and Noncommunicable diseases cluster (UHC-CND), and
(iv) Corporate Services and Enabling Functions (administration and management).
It is worth noting that over the last 3-5 years, Liberia has made significant progress towards UHC, health emergencies (HEP) and healthier populations (HPOP). However, some gaps show a negative trajectory towards some of the targets. Liberia will likely make a positive trajectory towards UHC by 2023, with some progress in 2022 in areas of average service coverage (Antiretroviral therapy (HIV), IHR core capacities, and hospital bed density). The negative trajectory anticipated by 2023 primarily regards the HEP and HPOP targets, specifically in routine immunization and nutrition, air quality, road safety, and WASH. The achievements cover key priority activities in the first year of the joint GoL-WHO Programme Budget 2022-23 and contribute to the GPW13 outcomes of the triple billion goals (accessing UHC, protection from health emergencies, and healthier populations) 2018 to 2025. Accordingly, the GPW13 has been extended with an additional two years focusing on five priorities to deliver concrete results and impacts in countries by 2030. These five priorities are:
- Support countries to make an urgent paradigm shift towards promoting health and well-being and preventing disease by addressing its root causes.
- Reorient health systems towards primary health care as the foundation of universal health coverage.
- Strengthen the systems and tools for epidemic and pandemic preparedness and response at all levels.
- Harness the power of science, research innovation, data, and digital technologies.
- Strengthen WHO as the leading and directing authority on global health.
The report also provides a detailed analysis of the role of partnerships and collaborations in driving progress and highlights the importance of continued investment in the health system for better health outcomes for the people of Liberia.
Health System Strengthening (UHC-HSS)
Liberia’s health system continues to face enormous challenges across all the six WHO building blocks and social determinants of health. These challenges include, but are not limited to, inadequate access to and utilization of essential health services (UHC Coverage Index of 42%), limited access to safe, affordable and effective medicines, inadequate sustainable financing, and an insufficient health workforce at all levels. To address some of these challenges, the WCO has provided targeted technical guidance and support to strengthen the health systems at all levels. These efforts have been based on and guided by the WHO Member States Action Framework for HSS towards UHC in the African Region.
Improving Leadership and Governance
- Provided technical and financial support to MoH and partners to review National Health Policy & Plan (NHPP 2011- 2021) and elaborate National Health Policy (2022-2031) and Health Sector Strategic Plan (HSSP) 2022-2026. The national health policy and strategic plan set policy and strategic direction and the medium to long-term framework on the interventions and resources required to deliver essential health services to the population in Liberia towards UHC and other SDG 3 targets.
- As part of efforts to strengthen and improve health sector coordination, WHO, in collaboration with MoH and other partners, completed a rapid assessment of the External Aid Coordination Unit, the secretariat responsible for overall health sector coordination in Liberia. The assessment identified critical gaps that MoH and partners will strengthen to improve health sector coordination.
Strengthening delivery of essential health services
- Completed developing Liberia’s first-ever costed Operational Plan for Emergency Care Systems. This followed a joint emergency and critical care systems assessment using the Global WHO Emergency Care System Assessment Toolkit. The plan’s implementation commenced with training 65 health professionals in Basic Emergency Care (BEC), creating a pool of certified national trainers in BEC.
- Completed validation of the second Essential Package of Health Services (EPHS II) for Liberia to cover the period of 2022-2026. Jointly funded, delivered, and monitored by the government and partners, the package defined essential services at all levels of the health systems and contributed towards achieving UHC and other SDG 3 targets.
- Installed and commissioned two modern oxygen plants: a duplex PSA plant with 50Nm3/hr capacity and a single PSA plant with 9Nm3/hour production capacity at Star Base and the Liberia Government Hospital Bomi, respectively. The two plants will produce approximately 120 cylinders of medical-grade oxygen per day to serve a population of about 2.3 million in five counties (Montserrado, Margibi, Bomi, Gbarpolu and Grand Cape Mount).
- Completed the first National Survey to measure progress in implementing the WHO Global Patient Safety Action Plan (2021–2030) with a consolidated national response submitted to the WHO-Global Patient Safety Network. The survey’s findings have informed the development of the national patient safety action plan as part of efforts to build a culture of safety and a sustainable patient safety programme in Liberia.
Improving access to and availability of essential medicines, medical products, and diagnostics
- Completed antimicrobial resistance (AMR) tripartite annual assessment and reporting for Liberia in collaboration with the National One Health Platform. The tripartite AMR country self-assessment survey and monitoring exercise critically reviewed and summarized the country’s progress and identified gaps in implementing key actions to address AMR at the national level to inform policy decisions and public health actions.
- Supported the MoH in assessing factors affecting medical commodity availability and security at healthcare facilities. This case study of nine counties has provided evidence on the causes of stock-out of essential medicines and proposed strategies to guide interventions by MoH and partners to prevent disruptions in crucial commodities at the last mile.
- Supported coordination, strategic partnership, and collaboration on AMR multi-sectoral response involving relevant sectors (Human, Animal, Environment) and agencies and other UN agencies. This led to successful joint planning and prioritization of AMR interventions by various partners using global and national baseline AMR data and commemorating World Antimicrobial Awareness Week.
Family and reproductive health and nutrition
The Family and Reproductive
Health (FRH) Unit comprises programmes focusing on the care continuum along the life course. The Unit continued its collaboration with the Family Health Programme (FHP) of the Ministry of Health primarily towards accelerated restoration and delivery of essential sexual reproductive health, maternal, newborn, child and adolescent health services and nutrition programmes in Liberia. Other collaboration and partnership areas for other priority programmes included gender, equity, and human rights mainstreaming. In addition, working with other health partners, including the UN, civil society, and other government sectors, like gender, youth, education and local government, the Unit realized quite a few optimal gains in improving SRMNCAH, gender and nutrition services.
- Sexual Reproductive Health
1.1. SRMNCAH data generation, monitoring, and tracking was strengthened by adopting the AFRO-recommended SRHR Scorecard indicators, thereby improving evidence-based lifesaving decisions and interventions towards preventing deaths and disability among pregnant women, neonates and infants. Approximately 20 professionals from the MoH, UN agencies, and civil society employees collaborated on this initiative.
1.2. Towards ensuring improved gender lens programmes and services, WHO built the gender mainstreaming capacity of 30 professionals across critical government sectors,
including health (MoH), gender (Ministry of Gender, Children and Social Protection), and education (Ministry of Education). Civil society and UN agencies also benefited.
- Maternal Newborn Quality of care
2.1. Liberia successfully contextualized the WHO electronic maternal and newborn Quality of Care tool by pre-testing it at two major hospitals in Monrovia. The localized version of the tool was used to determine the progress, gaps, and issues related to the quality of maternal and newborn health care services at the seven major hospitals.
2.2. The assessment findings were the reference for developing the national maternal and newborn quality of care improvement plan and seven hospitals’ specific quality of care improvement priorities. These will be used to mobilize resources and guide addressing the identified gaps.
- Child and adolescent health and development
3.1. Capacity was built to empower at-risk youth through self-care interventions and community social networks, boosting good health-seeking and practice.
3.2. Healthcare facilities in five selected communities were further capacitated by training 25 service providers for improved customer-friendly health care for at-risk youth. The training will deliver a harmonized quality of service approach at the health facility level for at-risk youth and young people.
3.3. The health and well-being of 125 at-risk youth improved by distributing and using self-care hygiene kits, contributing to their improved mental health status, reintegration into society, and better self-esteem.