The Ebola outbreak and the wider health system: understanding impact and exploring the way forward in Liberia through the case study of NTDs: Stakeholder Consultation Meeting Report, COUNTDOWN Consortium
Country Manager: Karsor Kollie
In Liberia the Neglected Tropical Disease programme is a priority of the Ministry of Health and Social Welfare and prioritized in national health policy and plan. Neglected Tropical Diseases are part of the Essential Package of Health Services (EPHS).
The integrated Neglected Tropical Disease programme became functional in 2012. The programme has a national Director and Coordinator for each disease condition including schistosomiasis/Soil Transmitted Helminths , Onchocerciasis, Lymphatic Filariasis/Guinea Worm and Buruli Ulcer. The aim is to reduce the burden of Neglected Tropical Disease to a level where it is no longer a public health problem which also impact socio-economic development.
There are areas of NTDs co-endimicity within Liberia and a mapping has been conducted for almost all of the Neglected Tropical Diseases. The government promotes a multi-sectoral approach (in agriculture, education, malaria control, and community health) in dealing with NTDs. They pro-actively include communities in line with Primary Health Care concepts. All NTDs programmes are integrated within the health system.
In line with the Liberian health policy, the NTDs programme is evidence based and in implementation they are steered by a need to be gender sensitive and responsive. They respect fundamental human rights and work to a high level of ethical standards. Implementation is driven by principles of good governance, transparency, accountability and prudent use of resources. They also try to respond to local realities, priorities and traditions.
In Liberia there is limited financial support for implementation especially the training and maintenance of health care workers and Community Drug Distributors. There is limited social science operational research to inform effective and efficient programme implementation.
There is also limited capacity building including training for NTD personnel in research.
A lack of Community Drug Distributor motivation is a challenge for Mass Drug Administration – as is a lack of incentives for most Neglected Tropical Disease staff. There is a weak synergy between frontline health services and the community. Hence, the near collapse of the already fragile health system due to the Ebola outbreak did not help.