Presented by: Mr. Tijli Tarty Tyee, Jr., BSc Economics, MBA, Economics

Inception Report from the Liberian Ministy of Health,

Republic of Liberia

Outlined:Introduction;Summary of Liberia’s Investment Plan

2015-2021Health Sector Reform Strategy;Health Workforce Program;Healthcare Financing;Fiscal Space Analysis;

Introduction:The Liberian Government (GoL)was making significant

progress in rebuilding its healthcare delivery system after almost two decades of civil unrest. We were in the process ofimplementing the National Health Policy & Plan (2011-

2021)with the introduction of the Essential Package of HealthServices (EPHS) which serves as the major indicator for measuring progress of the Liberian health recovery

following the civil unrest.

Introduction Cont’The EPH which is better described as the cornerstone

of theLiberian healthcare delivery system was disrupted due

tothe first round of the Ebola Virus Disease (EVD) early

detectionin Lofa County, March of 2014. This severe disease andsubsequent outbreaks in all 15 counties Republic of

Liberia wasa devastating blow to the entire health system and the

Liberianpopulation at large.

Introduction Cont’Within the space of one year, almost 9,500 cases

inclusive ofconfirmed, probable and suspected EVD cases werereported, of whom 4,241 death recorded. Healthcare

workers(HWs) suffered a disproportionate death toll (372 cases

amongHWs with 180 death). This situation resulted into essentialhealthcare services severely been disrupted, closer of

somemajor healthcare service institutions with in the country.However, adequate facts are yet to be established for theprolonged widespread of the virus.

Introduction Cont’

Similarly, preliminary findings from the 2014 Annual Report of

the Ministry of Health and the field assessments conducted in

early 2015 to inform the development of the Country’s

Investment Plan for Building a Resilient Health System revealed

several critical vulnerabilities in the health system including:

Continuation a) Inadequate number of skilled HWs with almost

50% of them not been placed on government’s official payroll;

b) Unsafe working conditions particularly related to infection prevention and control (IPC);

c) Erratic and uncoordinated supply chains for medicines and other essential health commodities;

d) Weak management and leadership skills at the district and county levels;

e) Limited operational funds at district and county levels to enable proper functioning;

f) Poorly functioning community surveillance systems and

g) Weak partnership between health authorities and their local communities.

Continuation:As we transitioned from the period of health crisis, the

LiberianGovernment, through the MoH, is leading a morecomprehensive nationwide efforts to firstly, provide safe andessential healthcare services and secondly, build a resilienthealth system over the long-term which provides healthsecurity by reducing risks due to epidemics and other healththreats as well as accelerating progress towards achieving auniversal health coverage by implementing access to safe andquality health services.

Summary of Liberia’s Investment Plan, 2015-2021The Liberian Investment Plan for Building a Resilient

HealthSystem clearly articulates the GoL’s priorities in

rebuilding arobust healthcare system to ensure it has the necessary

capacityto provide the essential healthcare services for the

people ofLiberia; indentify and respond to future health threats. Health System Strengthening is considered the cornerstone on which those improvements shall be built

uponand sustained.

Summary of Liberia’s Investment Plan, 2015-2021

Our Vision as a nation states: A Healthy

population with social protection sustain

for all.Our Mission: Build a resilienthealthcare delivery system

Summary of Liberia’s Investment Plan, 2015-2021Our Strategies: 1.Build a ‘fit for purpose’ productive and

motivated health workforce; 2.Re-engineer the health infrastructure;3.Improve the management capacity for

medical supplies and diagnostics; 4.Enhance quality service delivery systems; 5.Improve the epidemic preparedness,

surveillance and response system ;6.Comprehensive information, research and

communication management system;

Summary of Liberia’s Investment Plan, 2015-2021Our Strategies: 7. Sustainable community engagement;

8. Leadership and governance capacity; and 9. Efficient health financing systems.

Our high priority areas are: 1.Maternal and New bon Health;2.Leadership and Governance;3.Mental Health

Liberia’s Health Sector Reform Strategy:The Government of Liberia in collaboration with the GovernanceCommission (GC) and the Civil Service Agency (CSA) hasembarked upon a vigorous reform process in an attempt to

achievea sizable workforce, effective and strong to manage resources

with adesire salary based on qualifications and performance. The GC

hasbegun the process of implementing the mandate and functionalreview document across all line ministries, agencies andcommissions nationwide. As part of this holistic process, the

MoH incollaboration with the GC & CSA has embarked upon setting up

anInternal Reform Committee(IRC) which will eventually drive the

reformprocess.

Liberia’s Health Sector Reform StrategyAs part of this exercise, the MoH was tasked by

the GC to review the proposed mandate and functional

reviewdocument in order to make the necessary

changes. The processis ongoing and it is accompanied by a staffing

analysis initiative.Counties & Districts level structures are been

implementedgradually.

Liberia’s Health Workforce program:

The National Health Workforce pipeline assessment conducted in early

2014 seeks to answer: Why is there a health workforce shortage?

The Assessment reviewed: # of health workers being trained each year; # of health workers being recruited into the public health

workforce; # of health workers being retained by the health workforceData obtained from: focus group discussions, met with key

stakeholders todocument challenges; collected data form 22 health training

institutions;analyzed payroll on recruitment and retention; data was used to

understandkey barriers within the current healthcare delivery system.

Liberia’s Health Workforce program: without an intervention, Liberia will never meet workforce targets and the staff gaps will only continue to expand as the county’s population grows.ithout an intervention, Liberia will never meet national workforce targets and the staffing gaps will only c

Recommendation: Increase Training Capacity, MOH Recruitment and Retention

Health Workforce Program High Level Theory of Change

Five Priority Cadres: