Reducing Maternal Mortality in Liberia: The Tiawan Gongloe Prescription

The maternal mortality ratio (MMR) in  Liberia is alarming. According to the recent Demographic and Health Survey, the MMR of Liberia is 742 per 100,000 live births, one of the world's highest rates of maternal mortality. 

The United Nations International Children's Emergency Fund (UNICEF),  has listed Liberia as having one of the highest rates of deaths for newborns in the world: 76 in 1,000 births under-five mortality rate. The lifetime risk of a Liberian woman dying during pregnancy, childbirth, postpartum, or post-abortion is 1 in 10, in contrast to the lifetime risk in developed countries estimated at 1 in 5300. 

According to the 2023 Liberia National Abortion Report, about 38,779 induced abortion cases per year occurred in Liberia.  The study focuses on measuring abortion, the magnitude of complications, cost, and quality of post-abortion care.

 A range of social, economic, health, and other family pressures and complications are responsible for these abortions. Hemorrhage is responsible for 25% of deaths among women that suffer from maternal mortality. Life expectancy in Liberia is currently established at 64 years according to the WHO 2022 data; specifically 64 for males and 66 for females. 

Several studies have shown that there cannot be any meaningful development within a country without a robust health plan to cater to its citizens. Health is wealth. A healthy nation is a wealthy nation. However, in Liberia, it is a well-known fact, the country has problems with managing its healthcare delivery systems to the benefit of the majority of citizens. 

Due to poor management of available funds, the healthcare system in Liberia has fallen into even more dislocation and decay under the George Weah-led administration. What is more, the situation is complicated by systemic corruption, institutional inefficiency, and the lack of enough health facilities.

Our poor healthcare delivery system is complicated by our existing political elite who rather than develop the public healthcare delivery system in terms of good functioning health facilities, and services; concentrates on the construction of private alternatives and heavy reliance on foreign alternatives.

 In April 2001, the African Union (AU) countries met in Abuja and set a target of, at least, 15% of their yearly budget to improve the health sector. However, the  Government of Liberia has failed for the umpteenth time to meet the Abuja Declaration by African leaders in 2001 and the WHO to allocate, at least, 15 percent of yearly national budgets to health. 

While the public health delivery system decays in Liberia, the private sphere expands and gets all the benefits. The scarce resources are deployed to foreign trips for either medical tourism or to take advantage of better services. It is not unusual to hear of political elites that fly abroad for medical treatment and have their spouses go abroad for childbirth. 

For example, Finance and Development Minister, Samuel Tweah and his wife were flown to Ankara, Turkey for a medical checkup after a road accident. When the custodians of state power and the elite lose confidence in existing healthcare and other institutions, it usually culminates in a deeper disregard for health issues that affect the populace. 

Based on these figures, it is obvious that Liberia’s record is very poor. Liberia’s record is below countries such as Guinea, Ghana, Kenya, and South Africa. Successive governments in Liberia have indeed paid less attention, to varying degrees, to improvements in the area of maternal and infant mortality. 

The inconsistency in government policy especially in the area of primary health care delivery, insufficient staffing of health facilities, and lack of the necessary infrastructure resulting in avoidable delays- lack of beds, water, drugs, doctors, electricity, and other equipment to aid childbirth, high cost of well-equipped private hospitals, poor salary to hospital staff leading to a rather lukewarm or lackadaisical attitude of staff, and poor hospital or healthcare administration are the results of the high infant mortality & maternal mortality rates in Liberia.

Tiawan Gongloe Prescription

Tiawan Saye Gongloe, standard bearer of the Liberian People Party (LPP) and the presidential aspirant has listed priorities for fixing Liberia’s ailing health sector. He promised to tackle lots of issues, including Liberia’s degenerating roads, educational sector, national security, economy, women & youth empowerment, and most importantly to reform the country’s failing health sector.

While discussing his 10 points agenda titled: “A Better Liberia Is Possible” during his recent visits to Grand Gedeh, River Gee, Maryland, Sinoe, Grand Kru, and River Cess counties, Gongloe said his administration will tackle the high infant mortality and maternal mortality rates in Liberia. Gongloe promised free healthcare services for all pregnant women, children under 5, and Liberian citizens 65 years above. He said under his administration, public health centers, clinics, and hospitals would become the best in the country. 

According to Gongloe, Liberia’s public healthcare system has virtually collapsed. He promised to facilitate the upgrading, equipping, and staffing of hospitals, clinics, and health centers all over Liberia. So how does the LPP’s Standard Bearer intend to achieve this? Gongloe's plan includes increasing budgetary allocation to the health sector to meet the 15% recommendation for yearly health budget by African Heads of State (Abuja Declaration) and the World Health Organisation (WHO) in order to adequately fund the healthcare delivery system so it can deliver effective, good quality, and affordable services to all Liberians including free healthcare services to pregnant women, children under five, and citizens 65 years above. 

While in the southeastern region of the country, Gongloe told the people that corruption is impeding Liberia's growth and development and in the health sector it is not unusual for monies budgeted for healthcare projects to be diverted to other purposes in the national or personal interests of the official in charge or for approved funds to be poorly utilized due to poor supervision and monitoring. 

There are instances where substandard, fake, and dangerous drugs and equipment have been imported at the expense of mothers and infants. Also, he mentioned the reliance on non-professionals to provide leadership in the health sector is equally a problem and that will never be tolerated when he is elected president of Liberia.

Gongloe’s healthcare agenda includes supervision, coordination, and monitoring of healthcare delivery by agencies and institutions to ensure effective and efficient deployment of resources, implementation, and deliverables to all Liberians.  He promises as president he will make surprise visits to hospitals and clinics around the country and request medical checkups and if medical supplies or pieces of equipment are not available to perform his exam due to theft or mismanagement, he will immediately fire the head of the hospital or clinic and send them to the Liberia Anti-Corruption Commission (LACC) for further investigation and persecution. 

Gongloe emphasizes investing in health education to promote general awareness of health rights, promote disease prevention and improve public knowledge on obligations on health services in Liberia.  The challenges to his healthcare agenda will be the implementation of a sustainable financing mechanism, availability of medicines and consumables in health centers; promotion/communication on free healthcare to targeted vulnerable groups (pregnant women, children under five, and citizens above 65 years old), and improved facilities and modernization of health structure, but Gongloe is determined. 

According to him, if the healthcare delivery system isn’t suitable for the president then it isn’t suitable for the citizens. He argued that the impact of his plan would include increased use of health services, increase in the number of assisted childbirths, a downturn in maternal and child mortality, improved health of women, children, and elderly as well as improved household living standards in Liberia.

Tiawan Saye Gongloe entering presidential politics in Liberia is a breath of fresh air. He is arguably the only presidential aspirant that has laid out a comprehensive agenda for revamping the healthcare delivery system while reducing Liberia’s high infant mortality & maternal mortality rates. and orderly improving the quality of life and lengthening the life expectancy of the Liberian people.

Editor’s note: The views expressed in this commentary are solely of the author and do not necessarily represent that of the Daily Observer newspaper.