Health Systems Strengthening, World Health Organization - Country Office for Liberia, Monrovia, Montserrado, Liberia.
World Health Organization, Geneva, Switzerland.
Front Public Health. 2023 Jun 19;11:1137865. doi: 10.3389/fpubh.2023.1137865. eCollection 2023.
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict' Liberia is one of the three countries worst hit by the 2014-2016 West Africa Ebola Virus disease (EVD) outbreak, during which it recorded over 10,000 cases, including health workers. Estimates suggest that the non-EVD morbidity and mortality resulting from the collapse of the health system exceeded the direct impact of EVD. Lessons from the outbreak were clear, not only for Liberia but also for the regional and global communities: that building health system resilience through an integrated approach is an investment in population health and wellbeing, as well as economic security and national development. It is therefore no surprise that Liberia made recovery and resilience a national priority from the time the outbreak waned in 2015. The recovery agenda provided the platform for stakeholders to work toward the restoration of the pre-outbreak baseline of health system functions while aiming to build a higher level of resilience, informed by lessons from the Ebola crises. Based on the co-authors' experiences of on-the-ground country-support work, this study sought to provide an overview of the Liberia Health Service Resilience project (2018-2023) funded by KOICA, and propose a set of recommendations for national authorities and donors, derived from the authors' perceptions of best practices and key challenges associated with the project. We used both quantitative and qualitative approaches to generate the data represented in this study by reviewing published and unpublished technical and operational documents, and datasets derived through situational and needs assessments and routine monitoring and evaluation activities. This project has contributed to the implementation of the Liberia Investment Plan for Building a Resilient Health System and the successful response to the COVID-19 outbreak in Liberia. Although limited in scope, the Health Service Resilience project has demonstrated that health system resilience could be operationalized by applying a catchment and integrated approach and encouraging multi-sectoral collaboration, partnership, local ownership, and promoting the Primary Health Care approach. Principles applied in this pilot could guide the operationalization of health system resilience efforts in other resource-limited settings similar to Liberia and beyond.
本文是“COVID-19 和长期冲突背景下的卫生系统恢复”研究专题的一部分。利比里亚是 2014-2016 年西非埃博拉病毒病（EVD）疫情中受灾最严重的三个国家之一，疫情期间记录了超过 10000 例病例，包括卫生工作者。据估计，卫生系统崩溃导致的非 EVD 发病率和死亡率超过了 EVD 的直接影响。疫情带来的教训不仅对利比里亚，而且对区域和全球社区来说都很明确：通过综合方法建设卫生系统弹性是对人口健康和福祉、经济安全和国家发展的一项投资。因此，毫不奇怪，利比里亚从 2015 年疫情消退时起就将恢复和弹性作为国家优先事项。恢复议程为利益攸关方提供了一个平台，使他们能够努力恢复疫情前的卫生系统功能基线，同时旨在根据埃博拉危机的经验建立更高水平的弹性。基于合著者在实地国家支持工作中的经验，本研究旨在概述由 KOICA 资助的利比里亚卫生服务弹性项目（2018-2023 年），并从作者对与项目相关的最佳实践和主要挑战的看法出发，为国家当局和捐助者提出一系列建议。我们通过审查已发表和未发表的技术和业务文件以及通过情况和需求评估以及常规监测和评价活动得出的数据集，采用定量和定性方法生成本研究中表示的数据。该项目为实施利比里亚建设有弹性卫生系统投资计划和成功应对利比里亚的 COVID-19 疫情做出了贡献。尽管范围有限，但卫生服务弹性项目表明，可以通过应用集水区和综合方法并鼓励多部门合作、伙伴关系、地方所有权以及促进初级卫生保健方法来实现卫生系统弹性。在本试点中应用的原则可以指导在其他类似于利比里亚的资源有限环境中实施卫生系统弹性工作。
