The importance of investing in Liberia’s health system after Ebola

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In 2016, we launched our 2nd country programme by investing in the scale-up of a UNICEF programme to provide vital assistance to the Liberian Government after the country’s health system was devastated by Ebola. Our funding is supporting evidence-based nutrition interventions to replace those crucial services that were lost or disrupted during the Ebola epidemic.

When Ebola spread across Liberia in 2014, over 4,800 people died from the disease before the country was declared Ebola free in 2016.1 One of the biggest impacts of the epidemic was the disruption of the country’s health system. An estimated 157 health workers in Liberia died,2 with almost all basic essential health services severely disrupted as services were diverted to Ebola.3 During the epidemic, most health facilities closed and when they did reopen, many were under-resourced and patients were reluctant to attend them for fear of infection.4 Ebola had shaken Liberia’s already fragile health system.

Prior to the Ebola outbreak, stunting and undernutrition levels declined between 2007-2013, but there are concerns that this progress could now be undone. Ebola disrupted numerous activities aimed at reducing undernutrition; for example, the ‘no touch’ policy at health facilities, designed to prevent the spread of Ebola, restricted health workers assessing severe acute malnutrition in young children. Furthermore, as breastfeeding was proven to transmit the Ebola virus, the use of breastmilk substitution increased.

Our programme with UNICEF addresses a number of these issues and will help the government get back on track to meet their stunting targets. Critically, we’ll accelerate breastfeeding promotion and related educational campaigns and activities and train up to 700 frontline health workers and 1,000 community health workers. Not only does good nutrition boost brain development, it also reduces fatalities among children suffering from diarrhoea and pneumonia, and even infectious diseases.  Although our programme was prompted by the impact of Ebola on the health system, it will provide lasting support for children suffering from undernutrition in Liberia and we’ll be providing updates from the field in the coming months.

 

1 BBC News, Liberia Ebola epidemic ‘over’, ending West African outbreak, available at: http://www.bbc.co.uk/news/world-africa-35308743
2 World Health Organisation, ‘Health worker Ebola infections in Guinea, Liberia and Sierra Leone’, available at: http://www.who.int/hrh/documents/21may2015_web_final.pdf
3 Dr Marie-Paule Kieny, ‘Ebola and health systems: Now is the time for change’, World Health Organisation, December 2014, available at: http://www.who.int/mediacentre/commentaries/health-systems-ebola/en/
4 Dr Marie-Paule Kieny, December 2014 and Brolin Ribacke K. J. et al, Effects of the West Africa Ebola Virus Disease on Health-Care Utilisation – a systematic review, Frontiers in Public Health, 2016.