A responsive and resilient national health system is key to improving all citizens’ health outcomes, especially those who are most vulnerable. Liberia’s turbulent political history has shown that a strong health system is essential. JSI began working in Liberia in the late 1980s, collaborating with the Ministry of Health (MOH) to strengthen the health system and improve service quality through capacity building, technical assistance, and health worker training. We have continued this relationship over the years, and have implemented multiple programs with the aim of strengthening Liberia’s health system.
One of JSI’s most recent Liberian projects, the Resilient and Responsive Health Organizations (RRHO), builds the capacity of Liberia’s institutions, ranging from schools of nursing and midwifery to government ministries and regulatory bodies and has done so since 2018. RRHO aims to build organizational capacity and to provide resources that will allow local partners to sustain health system improvement efforts.
Most of JSI’s work in Liberia from 2014-2018 focused on strengthening the capacity of both the health system and the government during the Ebola outbreak. When Ebola hit first Liberia in 2014, the outbreak killed almost 5,000 people and exacted heavy social and economic losses across the country. Health workers were all needed to deal with the outbreak; many became infected, and fear and anxiety permeated society. JSI chaired the National Infection Prevention and Control (IPC) Task Force and providing support to national committees on case management, logistics, and contact tracing.
As Liberia’s health system recovered from the Ebola outbreak, JSI established the Rebuilding Essential Health Services (REHS) program with the MOH and the World Bank. The program focused on establishing essential primary care and improving infrastructure to support the restoration of essential health services in 24 health centers spanning nine Liberian counties. Additionally, in order to ensure that the system is resilient enough to withstand future public health emergencies, the program strengthened the capacity of emergency triage units in the 24 health centers to identify potential Ebola or other infectious disease cases.
In 2016, JSI’s Advancing Partners & Communities (APC) began its Ebola Transmission Prevention and Survivor Services (ETP&SS) program, which in 2018 reported a 35% increase in attendance to referral appointments; a 77% decrease of experience with Ebola-related stigma; and a 59% decrease in people delaying or avoiding care.
In early 2015 the Liberia Infection Prevention and Control Activity (IPCA) began. Through this project, JSI staff trained health workers on how to keep themselves and their patients safe and ensured that supplies and resources were distributed efficiently and effectively to all operational health facilities
Building capacity in the war-torn country has also been critical. The Liberia President’s Young Professionals Program, launched in 2010, recruited young Liberians in America who were dedicated to public service and placed them in operational roles throughout the Government of Liberia. This initiative strengthened the administrative capacity of Liberia’s government as well as strengthened the skills of a generation capable of bringing about long-term change in Liberia’s political and health systems.
The Liberia Rebuilding Basic Health Services (RBHS) project deepened JSI’s role in rebuilding Liberia’s fragmented, post-conflict health system. The project was designed to help the health system transition from relief support to self-reliance. Working with the MOH, JSI designed and implemented Liberia’s first performance-based financing system to build public sector systems and capacity, update and standardize pre-service curricula, strengthen teaching quality, design a decentralized health management information system, provide trainings and policies, build targeted health infrastructure, and launch the Liberian Health Equity Fund. Later, RBHS shifted to help the government fight Ebola, setting up a logistics system to track the massive inflow of supplies, including personal protective equipment, body bags, and IV fluids.
JSI has long been focused on health systems strengthening. We’ve partnered with the government and people of Liberia to provide and improve health services. The USAID funded Maternal and Child Health Integrated Program addressed Liberia’s provision of family planning services through health workers. Over the course of the project, MCHIP led national advocacy efforts, increased access to and coverage of quality family planning services, and stimulated the demand for services at the community level.
To strengthen the country’s supply chain DELIVER designed, developed, strengthened, and operated reliable and sustainable public health supply chains, with a focus on capacity building, institutional development, and systems strengthening from 2006 to 2015. The project worked closely with the MOH, National Malaria Control Program, Family Health Division, National Drug Store, and Supply Chain Management Unit.
Our work in Liberia first began to accelerate between 2006 and 2007, just after the end of Liberia’s civil war. The USAID-funded BASICS project partnered with the MOH until 2009 and designed and implemented country-level plans to support decentralization. JSI was instrumental in developing Liberia’s first post-conflict transition assessment, which examined what would happen if relief funding stopped. This assessment sparked the government to move its health system toward self-reliance.
JSI- and our staff- are committed to partnering with the people and the government of Liberia. Together with our local and global partners, we will continue strengthening Liberia’s health system to ensure it can be responsive and resilient for generations to come.