Liberia
Goals of the partnership with NCD Synergies
NCD Synergies and PIH Liberia have been partnering with the Liberia Ministry of Health and Social Welfare since late 2015 to support national planning for NCDs in Liberia. As part of its post-Ebola recovery strategy, Liberia is developing comprehensive human resources for health strategies to address the greatest bottleneck to health service delivery, and is working with PIH and other partners to integrate NCD and injury services into these efforts. Improving existing data and prioritizing clinical interventions that can be delivered by health workers will have a significant impact on access to NCD care for the very poorest in Liberia.
Project milestones
- Liberia established a National NCDI Poverty Commission in February 2017 and expects to release a final report in 2018.
- Through support from the Helmsley Charitable Trust, PIH Liberia and NCD Synergies will be working closely with the Liberia Ministry of Health and Social Welfare to scale up NCD services and support clinical education in southeast Liberia as a potential national center of excellence for care for severe, chronic NCDs that impact Liberia’s poorest populations, such as type 1 diabetes.
- In November 2015, NCD Synergies began a short-term secondment to the Liberia Ministry of Health and Social Welfare to support national planning for NCDs in Liberia, in the wake of the Ebola crisis. This work, continuing through the National NCDI Poverty Commission, has focused on integrating emergency planning into broader health systems rebuilding, NCD national planning, and service introduction and scale-up for NCDs.
Liberia NCDI Poverty Commission
In February 2017, Liberia established a national NCDI Poverty Commission, focused on national priority-setting for NCDs in settings of poverty. The Liberia NCDI Poverty Commission is chaired by Dr. Fred Amegashie, the Director of the NCD Division for the Liberia Ministry of Health and Social Welfare, and Dr. Jason Beste, the Director of Clinical Services from Partners In Health Liberia. Dr. Amegashie and Dr. Beste are joined by a diverse group of seventeen national experts representing the Ministries of Health and Social Welfare, Education, Justice, and Gender, Children, and Social Protection, as well as NGOs, hospitals, and research institutions.
The Liberia NCDI Poverty Commission led by Dr. Fred Amegashie and Dr. Jason Beste meet in Monrovia
The story of NCDs and injuries in Liberia
Liberia is a small country in West Africa of 3.5 million people. The country is rebuilding its health system after a 14-year civil war during which 90 percent of health professionals fled the country, and recently faced one of the worst recorded Ebola outbreaks in history. Half of the population lives in remote rural areas with little or no access to basic healthcare. Many Liberians live on less than $1 a day, and the country had a per capita GDP of $414 in 2012. Though it is one of the poorest countries in the world, Liberia was spending approximately 15.5 percent of GDP on healthcare before the Ebola outbreak.
Prior to Ebola, noncommunicable diseases and injuries accounted for a large number of visits to hospitals, which indicates a need to bring treatment closer to patients and to make diagnoses earlier in the progression of disease. As the virus has destabilized the health system and reduced the health workforce, the burden of untreated NCDs grew alongside the Ebola epidemic. Since the crisis, the Liberia Ministry of Health and Social Welfare has engaged in a multi-year planning and assessment project to expand NCD treatment in a way that will serve the poorest and hardest to reach patients. This work focuses on integrating emergency planning into broader health systems rebuilding, revisiting NCD national policies and plans, and service introduction and scale-up.
National milestones
- Through a technical working group, the NCD Division has convened local NCD specialists and other experts to gather facility and survey data (including the WHO STEPwise approach to Surveillance or STEPS survey) on the burden of NCDs in Liberia. That data has been included in the draft National Policy and Plan for NCDs, which will also propose a service scale-up calendar.
- The Liberia Ministry of Health and Social Welfare has engaged with Last Mile Health and other partners in pilot projects focused on the development of comprehensive primary healthcare programs, such as Last Mile Health’s deployment of frontline health workers (FHWs) in the Konobo district of Liberia.
Page sources: Last Mile Health, World DataBank, UNICEF, UN MDG database, thanks to Renato Quispe Ayala for research.