The Ministry of Health (MOH) has drawn up an ambitious six-month plan for the immediate transition from Ebola virus disease (EVD) response to the restoration of basic health services.
It is no secret that the nation’s health sector completely collapsed in 2014 when the deadly EDV tested the “gains” that health stakeholders boasted they had attained before Ebola struck.
Despite their declared gains, stakeholders still admitted in their 2100-word transitional plan that weaknesses existed. MOH authorities attributed those weaknesses in the nation’s health system to what they described as “multiple factors such as capacity,systemic, financial, contextual issues relative to the prolonged period of instability and structural flaws.”
Those things were left “unaddressed while rebuilding,” and “all combined and collapsed the system with the onslaught of the EVD outbreak,” they said.
Health authorities confessed that as a consequence of those “weaknesses,” “massive deaths occurred in the affected communities, including an unprecedented number of healthcare workers.
Out of 340 reported EVD cases among health care workers the death toll was 179. Such mass post-conflict casualty and the resulting trauma and strains on the society have eroded public confidence [in the health sector].”
The Ministry’s transitional plan, which was ear-marked to be realized by June 2015, targets eight thematic areas, some of which had long since before EVD, been a part of the blueprints of the Ministry.
Those areas selected for immediate action towards restoration of basic health services include building a good Human resource capacity, Laboratory services at health facilities, EVD funds realignment and Infrastructure such as ETUs and Community care centers (CCC). Others are logistics and supplies, surveillance, preparedness and response, community engagement and coordination.
It is not clear if President Ellen Johnson Sirleaf’s recently announced 10-year program to develop the nation’s healthcare system includes the Ministry’s 6-month transitional plan, which some health commentators have described as having “more holes and won’t amount to anything tangible in the six-month time frame.”
The President said in her April 3rd address to the nation that her administration would embark on the 10 year plan because Ebola had exposed the weaknesses in the sector.
The program’s areas of concentration, according to Madam President, would be to train health care professionals, improve and expand services at primary and secondary healthcare centers, upgrade county hospitals and establish three regional referral hospitals in the country.
These objectives are to be achieved in 10 years not six months. However, President Sirleaf’s administration ends in 2017
In the President’s nationwide address, she admitted “We were invaded by an enemy we did not know and were not prepared to confront and which caused the deaths of many of our fellow citizens and robbed many more of their livelihoods.”
Since the Ministry’s plan was not included in the President’s speech, is it possible for the Ministry to achieve them?
Under the human resource capacity component of the plan, the Ministry has at least six priority areas to include taking stock of foreign medical teams and deploying them, based on expertise and experience, to health training institutions, hospitals and counties. Another priority is the payment of all hazard and risk benefits to all health staff and communicating an end date for that payment. Along with the all-risk benefit, a formal in-service training program would be established on infection control, with regular continuing education for all those involved in delivery of health services in Liberia.
The Health Ministry said under the laboratory section, it intends to use current laboratories at regional and county levels to strengthen services; take stock of EVD specimens and establish a bio-bank and a system for accessing the specimens for research. Current staff in the EVD lab will be trained to carry out Ebola, Lassa fever and Yellow fever tests.
MOH further stated that in order to realign Ebola funds, it intends to pull all extra financial resources for tracking under the ministry’s financial management system. It will also conduct financial resource mapping for realignment to EVD and restoration of health services.
Under its plan for Infrastructure, ETUs and community care centers (CCC), by June 2015, it should have established permanent infectious disease wards in county hospitals; establish triage in all health facilities to properly screen all patients and protect health workers and their non-medical staff.
Regarding logistics and supplies, the Ministry said in the time frame, it hopes to conduct assets transfer and transition to support restoration of basic services. It will take stock of EVD and non-EVD supplies, medicines, non-medical supplies, nutritional supplements and food supplies and align them for the restoration of health services and strengthening the delivery and storage of pharmaceutical and medical supplies.
The Ministry said in order to have effective surveillance, to be prepared and ready to respond, it intends to maintain the current health referral structures (community, health facilities, Ebola units and schools); and transfer surveillance responsibilities including case detection, investigation, contact tracing, etc. to the county health teams (CHTs). It also wants to integrate the call center and dispatch center and transition the unit to the J.F.K. Memorial Hospital.
Under its last component of coordination, the Health Ministry’s authorities said in the event of Liberia being declared free from Ebola, the Incident Management System (IMS) will transition to a health sector coordination mechanism and review the terms of reference and structure of the national disaster commission and expand it to include epidemics and disasters.
“This transitional plan is an immediate effort and connective tissue between the effective efforts employed to combat the outbreak and a continuation of pre-Ebola health investment plan towards the national development agenda.”
While the objectives of the Ministry’s first 6-month plan expected to be accomplished by June 2015 are yet to be achieved, our health correspondent has reliably learned that stakeholders are set to meet today, April 6, to discuss another 6-month transitional plan which has been drawn up for July to December 2015. They are meeting at the Paynesville City Town Hall.