Geographical Locations - Liberia

• (Statistical) Number of Inhabitants per Doctor: 9,324
• CIA World Factbook : Liberia

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Liberia
  - WHO - Tobacco Control: Country Profile - Liberia
  - WHO - Environmental Burden of Disease: Country Profile – Liberia
  - WHO - Malaria Country Profile - Liberia
• WHO - Regional Office AFRO in Brazzaville, Congo

Government

Non-Government

• IRC in Liberia
  The IRC's programme focus in Liberia is providing emergency assistance to those displaced by violence. It has advocated extensively for and has provided a variety of services to the women and children associated with the fighting forces, and is currently working with a number of communities in Nimba, Lofa and Bomi counties to prepare for the imminent return of more than 420,000 refugees, internally displaced and ex-combatants to these three counties.
• Médecins Sans Frontières

Academic Institutions

National Policy and Related Documents

• Draft National Malaria Strategic Plan, 2009 – 2013
  "Malaria is endemic in Liberia and the entire estimated population of more than 3.6 million is at risk of the disease. Children under five and pregnant women are the most affected groups. The Liberia Malaria Indicator Survey (LMIS, 2005), the only national malaria survey done in postwar Liberia, show that malaria accounts for over 38% of out patient department OPD attendance and 42.30% of in-patient death (compared to 18% prior to the war). Based on the current estimated access to health care of 41%, approximately 1,813,709 cases of malaria are expected to be treated in 2007. Since August 2005, with funding largely from the Global Funds, some progress has been made in terms of the use of more effective malaria control and prevention strategies based on WHO Roll Back Malaria recommendations." [Malaria Control Program, Ministry of Health & Social Welfare, Republic of Liberia]
• Liberia Poverty Reduction Strategy
  "Liberia's Poverty Reduction Strategy (PRS) articulates the Government's overall vision and major strategies for moving toward rapid, inclusive and sustainable growth and development during the period 2008-2011. Specifically, the PRS will be implemented between April 1, 2008 and June 30, 2011 (the end of the 2010/2011 fiscal year). This period is of critical importance as Liberia shifts from post-conflict stabilization to laying the foundation for inclusive and sustainable growth, poverty reduction, and progressing toward the Millennium Development Goals (MDGs)."
• National Health Policy and National Health Plan, 2007-2011
  "The National Health Policy and Plan have been prepared with a theme of decentralization. We understand that the Liberian people are our most important and fundamental resource. A trained, educated, and skillful workforce must be the foundation for increasing access to quality health services. Particularly in rural and poor urban areas, building the human capacity of the health sector at the community, district, and county levels is an essential component of the national health reform process and policy implementation. This will involve the building of skills at every level in our health care system, from the floor sweeper and grass cutter to the head nurse and the senior surgeon. When we have achieved our first goal of skill- and capacity-building, the process of making difficult decisions concerning resource management and service delivery will be the logical and fully attainable next step. In this way, the health care system can move towards a healthy and immensely satisfying future. The Basic Package of Health Services is the cornerstone of the new Liberian national health care delivery strategy. The Ministry of Health and Social Welfare is committed to ensuring equity and quality through the delivery of the Basic Package of Health Services, including essential preventive and curative care services to be provided at every level of the health system, from the village health worker to major regional referral hospitals." [Republic of Liberia, Ministry of Health & Social Welfare, Monrovia, Liberia, 2007]
• Strategy and Implementation Plan for the National Health Management Information System
  "Emerging from more than 14 years of destructive war, Liberia is highly committed to attaining an acceptable standard of health for its entire population in the shortest possible time. The Health Policy Framework 2007 and the National Health Plan (NHP) 2007–2011 have clearly described national goals and priorities. The Health Management Information System (HMIS) has been considered one of the health system’s essential building blocks and, therefore, has been placed as a high priority item. A separate Health Management Information System Policy has been developed to guide the information system design and operationalization. This strategy is guided by the HMIS Policy 2008 that embraced the framework and standards set by the Health Metrics Network. The HMIS thus developed will meet international standards and be fully compatible with health management information systems in the majority of low– and low– to middle–income countries worldwide." [The [Liberian] Ministry of Health and Social Welfare, June 2009, in conjunction with USAID/Liberia and the USAID/BASICS]

Reports, Guidelines, and Projects

• Assessment of Health Training Institutions in Liberia
  "The assessment’s purpose was to examine the state of the infrastructure, human resources (faculty and staff) and academic standards of selected private and public training institutions to inform strategic directions of the ministry and its partners for the development and deployment of needed human resources for the implementation of the essential package of basic health services as defined in the National Health Policy." [USAID, MOHSW, AED, April 2007]
• Association of Combatant Status and Sexual Violence With Health and Mental Health Outcomes in Postconflict Liberia
  Context: Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized. Objectives: To assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health. Design, Setting, and Participants: A cross-sectional, population-based, multistage random cluster survey of 1666 adults aged 18 years or older using structured interviews and questionnaires, conducted during a 3-week period in May 2008 in Liberia. Main Outcome Measures: Symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), social functioning, exposure to sexual violence, and health and mental health needs among Liberian adults who witnessed or participated in the conflicts during the last 2 decades. Results: In the Liberian adult household–based population, 40% (95% confidence interval [CI], 36%-45%; n = 672/1659) met symptom criteria for MDD, 44% (95% CI, 38%-49%; n = 718/1661) met symptom criteria for PTSD, and 8% (95% CI, 5%-10%; n = 133/1666) met criteria for social dysfunction. Thirty-three percent of respondents (549/1666) reported having served time with fighting forces, and 33.2% of former combatant respondents (182/549) were female. Former combatants experienced higher rates of exposure to sexual violence than non-combatants: among females, 42.3% (95% CI, 35.4%-49.1%) vs. 9.2% (95% CI, 6.7%-11.7%), respectively; among males, 32.6% (95% CI, 27.6%-37.6%) vs. 7.4% (95% CI, 4.5%-10.4%). The rates of symptoms of PTSD, MDD, and suicidal ideation were higher among former combatants than non-combatants and among those who experienced sexual violence vs. those who did not. The prevalence of PTSD symptoms among female former combatants who experienced sexual violence (74%; 95% CI, 63%-84%) was higher than among those who did not experience sexual violence (44%; 95% CI, 33%-53%). The prevalence of PTSD symptoms among male former combatants who experienced sexual violence was higher (81%; 95% CI, 74%-87%) than among male former combatants who did not experience sexual violence (46%; 95% CI, 39%-52%). Male former combatants who experienced sexual violence also reported higher rates of symptoms of depression and suicidal ideation. Both former combatants and non-combatants experienced inadequate access to health care (33.0% [95% CI, 22.6%-43.4%] and 30.1% [95% CI, 18.7%-41.6%], respectively). Conclusions: Former combatants in Liberia were not exclusively male. Both female and male former combatants who experienced sexual violence had worse mental health outcomes than non-combatants and other former combatants who did not experience exposure to sexual violence. [author abstract] [JAMA 2008; 300(6): 676-690]
• Introducing health facility accreditation in Liberia
  In recent years, dozens of countries have introduced accreditation and other quality improvement initiatives. A great deal of information is available regarding best practices in high- and middle-income countries; however, little is available to guide developing nations seeking to introduce an accreditation programme. This paper describes the outputs and lessons learned in the first year of establishing an accreditation programme in Liberia, a developing nation in West Africa that in 2003 emerged from a brutal 14-year civil war. The Liberian experience of developing and implementing a government-sponsored, widespread accreditation programme may provide insight to other low-income and post-conflict countries seeking a way to drive rapid, system-wide reform in the health system, even with limited infrastructure and extremely challenging conditions. [author abstract] [Global Public Health, First published on 8 July 2010 (iFirst)]
• Risky Sexual Behavior among Urban Youth in Post-Conflict Liberia
  Globally, young people aged 15-24 years account for an estimated 45% of new HIV infections; of which, Sub-Saharan Africa (SSA) is gravely affected (UNAIDS 2008). Liberia, a country west of SSA has not escaped the massive and terrible effect of this HIV/AIDS epidemic, especially among vulnerable populations like youths. For example, HIV prevalence among 15-24 year-olds was estimated as 5.7% (NACP Survey report 2007), which is generally assumed to be higher than reported. However, scanty information is available on the HIV risk behaviors of urban youth in post-conflict Liberia. In this presentation, we report the correlates of risky sexual behaviors from the baseline data of 709 youth aged 15-17 years enrolled in an ongoing randomized controlled trial (RCT) with 12-months of follow up. We anticipate that the findings from this report has the potentially to contribute to the research and policy gaps associated with risky sexual behaviors in post-conflict Liberia. [author abstract] [Paper presented at the 2009 Annual Meeting of the Population Association of America, Detroit USA, 30 April – 2 May 2009]
• Universal, Quality, and Equal Access to Health Care to All Liberians: Situational Assessment of Liberia's Capacity for Performance-based Contracting of Non Governmental Organizations for the Delivery of the Basic Package of Health Services
  "When the fourteen year war, civil strife, and violence ended, health care service delivery was fragmented and uneven, and heavily dependent on donor-funded vertical programs and international NGOs. Since that time, and particularly since the democratic elections in 2005, Liberia has taken bold steps to transition from an emergency relief model of health service delivery to the development of a functioning, decentralized health system where counties are responsible for operational management of health services with support from the central Ministry of Health and Social Welfare and a diverse set of partners. The cornerstone of this decentralized primary care approach is the delivery of a Basic Package of Health Services (BPHS) to be provided at each level of facility in Liberia. The Ministry of Health and Social Welfare defined its vision for their national health system in January 2007 through the National Health Policy and a five-year National Health Plan (2007-2011). The plan defines a framework for shifting from emergency humanitarian relief to development and from vertical programs to an integrated health system." [Republic of Liberia, Ministry of Health and Social Welfare, May 2008]

Educational Resources

• CDC Travelers' Advice - West Africa