Liberia: Gov’t to Launch 10-Yr National Community Health Policy



— During the upcoming 3rd International Community Health Workers (CHW) Symposium in Monrovia

The government, through the Ministry of Health (MOH), is expected to launch a new ten-year national community health policy for 2023–2032.

The policy, which is intended to be launched during the Third International Community Health Workers (CHW) Symposium in Monrovia, scheduled for March 20-24 this year, will expand access and delivery of high-quality services to all communities through a government management community health workforce.

Making the disclosure on January 16, Health Minister Dr. Wilhelmina S. Jallah, revealed that as of 2022, there are 469 Community Health Services Supervisors (CHSSs), 4,331 Community Health Assistants (CHAs), and 5,060 Community Health Volunteers (Community Health Promoters, or CHPs); this is the largest grassroots employment of the government of Liberia.

“Given the immense gains made through our National Community Health Program, it is now a key pillar of the Liberian health care delivery system and a new ten-year National Community Health Policy (2023-2032) is poised to be launched during this 3rd International CHW Symposium,” she maintained.

Minister Jallah noted that the new policy will also contribute to the reduction of morbidity and mortality through the provision of a high-quality, cost-effective, standardized essential package of community health services and mitigate potential public health risks in all communities.

She averred that the government of Liberia has taken the lead in driving the community health agenda on the African continent and around the world by ensuring that it is well integrated into the larger healthcare system.

“To date,” Minister Jallah said, “the Ministry of Health, through its Community Health Services Division, has remained focused in its engagement with the Africa Center for Disease Control Community Health initiatives in providing the needed technical assistance to some member states to expand community health programs on the continent.”

According to her, as a global exemplar, Liberia “has demonstrated strong leadership — the leadership that enabled us to rise from the devastating effects of the Ebola outbreak and the on-going COVID-19 pandemic.”

She said, “To share this success story and launch our new ten-year National Community Health Program Policy and Strategy (2023–2027), Liberia bid in 2019 to host the 3rd International Community Health Workers Symposium and was awarded the bid by the Health System Global (HSG), Community Health Workers TWG, on June 29, 2020.” 

Minister Jallah maintained that Liberia’s National Community Health Program has gradually advanced and made significant progress since the 2014-2015 Ebola epidemic, when Liberia saw a complete breakdown in its healthcare delivery system, prompting the government to place the rebuilding of the health system at the top of its development agenda, as is evidenced in the progress that has been made.

She also stressed that based on the priorities outlined in the Post-Ebola Investment Plan for Building a Resilient Health System, the government set a roadmap to rebuilding a resilient health system to provide health security to all people, reduce risks due to epidemics and other health threats, accelerate progress towards universal health coverage, and create a national CHA program as part of a "fit for purpose" health workforce and contribution towards sustained community engagement.

“Thus, with support from partners, the Ministry of Health revised the National Community Health Services Policy for the period of 2016–2021,” said Minister Jallah. According to her, a key element of the revised policy was the institutionalization and integration of the National Community Health Program into Liberia’s health system.

"This revised National Community Health Services Strategic Plan provided the framework needed to ensure the full implementation of the Policy and execution of identified activities under the Strategic Investment Areas in the Investment Plan, most notably Sustained Community Engagement and the fit-for-purpose, productive, and motivated health workforce with the goal to extend the reach of the country’s primary health care system through an integrated and standardized national Community Health Model that will provide a package of essential life-saving primary health care services and epidemic surveillance within communities and to households on an equitable basis," she added.

Minister Jallah said since its launch in 2016, the National Community Health Program has not only transformed the healthcare delivery system but also increased access to quality and affordable care at the doorsteps of rural communities.

“Our Community Health Workers have conducted 8.9 million home visits, including 551,951 pregnancy visits; treated 905,184 childhood cases of malaria, pneumonia, and diarrhoea; and conducted 1.2 million screenings for malnutrition cases; provided 446,388 women with access to family planning services; referred over 355,000 pregnant women for antenatal care and facility-based delivery; and identified and reported about 7,106 potential epidemic events, excluding COVID-19,” she added. 

Minister Jallah noted that despite many health system challenges, the National Community Health Program has contributed to an increase in access to essential health services; as of December 2022, CHAs have increased equity in access to health services, reaching more than 70% of Liberia’s remote rural population of 1.5 million; 25% of all positive malaria diagnosis by Rapid Diagnostic Tests are now done by CHAs at the community level since 2018; between 2018 and 2022, there was a 50% increase in confirmed malaria cases, highlighting the role of CHAs; as of December 2022, a total of 619,233 malaria, 182,560 cases of pneumonia, and 122,110 cases of diarrhea were treated by CHAs; and 1,193,865 children under five have been screened and treated by CHAs; between CHAs in 2018

“The current population served by our Community Health Workers is about 1.5 million of our nation’s rural communities in 6,333 communities in 89 health districts in 15 counties.” She continued, “To date, there are a total of 4,331 CHAs and 469 Community Health Services Supervisors.”

Minister Jallah said, additionally, CHAs and their supervisors were already in place at the start of the COVID-19 pandemic and continued to provide essential services to their communities through detection, prevention, and response despite interruptions of services in most of the country’s health facilities.