Building on decades of partnership and collaboration with the Government of Liberia (GOL), USAID/Liberia’s health program seeks to improve the health status of all Liberians, especially the most vulnerable: women, girls, and children under age five.
USAID pursues this goal through interventions that support the GOL’s Investment Plan for Building a Resilient Health System in Liberia. Our work is guided by the following objectives:
- Increased utilization of quality Reproductive, Maternal, Newborn, and Child Health Services;
- Increased effectiveness of the health systems at national and county levels;
- Improved government capacity to control infectious diseases; and
- Increased access to safe water and sanitation.
To ensure the maximum benefit from U.S. government (USG) investments, USAID supports high-impact Maternal, Newborn, and Child Health (MNCH), Family Planning, Reproductive Health, Malaria, and interventions for ending preventable child and maternal deaths through strengthened health systems and increased access to quality health services.
USAID’s health program has six major components: Service Delivery involving government to government funding for primary health care services, PEPFAR care and treatment, Social Behavior Change Communication and Private Sector engagement; Health Systems Strengthening (HSS) technical assistance; President’s Malaria Initiative (PMI); Commodities and Supply Chain; Global Health Security Agenda (GHSA) program support and technical assistance; and Water, Sanitation and Hygiene (WASH) program support. Additionally, Liberia is receiving COVID19 American Rescue Plan Act (ARPA) Global Health Vaccine Readiness support.
SERVICE DELIVERY
Aligning with USAID’s core principles of country ownership and integrated health systems for sustainable impact, the centerpiece of USAID’s assistance for strengthening the quality and availability of facility-based healthcare service delivery is through USAID’s Government-to Government (G2G) agreement (Health Partnership) with the Ministry of Health (MOH). The Activity builds on the previous 10-years of G2Gs (FARA) and is focused on specific priority areas (MNCH/FP, Malaria and WASH) within the MOH’s Essential Package of Health Services. The Activity also contributes to key targets, strategies, and interventions in the Government of Liberia’s (GOL) 2018 Pro-Poor Agenda for Prosperity and Development Pillar 1 (Power to the People), section 2.3 (Expanding Access to Essential Health Services), and other Government of Liberia Health plans and policies.
The purpose of the Health Partnership is to stimulate improved maternal, newborn and child health, family planning and reproductive health, and malaria service delivery, improved point of care quality including water, sanitation, and hygiene; and strengthened decentralized health governance for marginalized rural populations in focus counties. The five-year (January 2022 – December 2026) Activity is implemented through performance-based financing (fixed amount reimbursement). The eight focus counties are Bong, Lofa, Nimba, Grand Gedeh, Grand Cape Mount, River Gee, Grand Bassa, and Margibi. The G2G is the core service delivery activity around which Community Health and Health Systems Strengthening are built and work in concert with.
At the community level, USAID support expands access to and use of quality primary care services by training community health assistants and disseminating behavior change messages; expanding access to immunization services and information for children under five; supporting an environment in which youth feel empowered to seek health care; expanding access to clean drinking water; supporting integrated community case management of childhood illnesses; and improving sanitation and hygiene through community-led sanitation initiatives.
USAID, through the President’s Emergency Plan for AIDS Relief (PEPFAR), provides technical and financial support for HIV epidemic control in Montserrado County, Nimba and Margibi Counties, with a particular focus on key populations at highest risk of the virus. This support includes community outreach, innovative and high-impact testing, and support for retention in treatment.
USAID/Liberia partners also work on integrated Social and Behavior Change (SBC) collaboratively with the Ministry of Health (MOH) at the national and subnational levels, and in complementarity to relevant USAID Implementing Partners (IPs), to improve the effectiveness of SBC and to implement quality SBC activities that will result in improved demand and use of health services for: malaria; maternal, neonatal, and child health (MNCH); family planning/reproductive health (FP/RH); adolescent health; and water, sanitation, hygiene (WASH); and informed communities engaging in behaviors to prevent zoonotic and non-zoonotic infections in line with the Global Health Security Agenda (GHSA). Lastly, USAID supports strengthening the Liberia Healthcare Federation of private sector healthcare providers in Liberia to improve quality and efficiency within the sector and strengthen the relationship between the public and private sectors.
HEALTH SYSTEMS STRENGTHENING
USAID/Liberia’s Health Systems Strengthening portfolio covers a comprehensive set of activities to support the Ministry of Health and the National Public Health Institute of Liberia. USAID’s investments focus specifically on supporting the Ministry through specific technical assistance at the central, county, and district levels to improve leadership and governance capacity for stronger, decentralized management of health services; to ensure the availability and financial viability of health services; to manage and maintain an adequately-sized workforce of qualified health care providers; to improve the quality, availability, and use of health information systems data; to support quality assurance and quality improvement at all levels of the health system; and to manage the supply chain, storage, and distribution of health commodities and medicines. Technical assistance is provided at the central and county-levels by embedded advisors who work side-by-side with their Ministry of Health counterparts.
PRESIDENT’S MALARIA INITIATIVE
President’s Malaria Initiative (PMI) activities are integrated throughout USAID’s portfolio and are focused on improving malaria case management, promoting the quality of medicines, preventing malaria during pregnancy, integrating vector management, and strengthening the health commodity supply chain system to improve availability of medicines to the end users. PMI also provides technical advisors who are embedded within the National Malaria Control Program to support key operations. The vision of the Liberia malaria program is a healthier Liberia with universal access to high quality malaria interventions with no malaria deaths. USAID’s PMI program support is coupled with Global Fund interventions in preventing, treating, and controlling malaria.
WATER, SANITATION AND HYGIENE
USAID supports the Liberia Water and Sewer Corporation with the rehabilitation and expansion of three water treatment plants in the county capital cities of Robertsport, Sanniquellie, and Voinjama, reaching approximately 30,000 Liberians. In addition, high-impact water, sanitation, and hygiene (WASH) interventions are integrated into key health activities at both the facility and community levels. At the community level, WASH interventions improve sanitation through community-led sanitation and hygiene promotion activities. Community level interventions expand access to clean drinking water by constructing hand dug wells and the community adoption of point-of-use water treatment technologies.
COMMODITIES AND SUPPLY CHAIN
Commodities and supply chain efforts in Liberia procures needed medications and supplies in support of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the U.S. President’s Malaria Initiative (PMI): Population and Reproductive Health (PRH) supporting family planning (FP) services and reproductive health programs; and Maternal and Child Health and Nutrition, that seeks to end preventable child and maternal deaths. Areas supported in Liberia include Coordination, Forecasting and Supply Planning; Health commodities procurement; Warehousing and Distribution; County Supply Chain Support; Workforce Development; End Use Verification Survey; Data Visibility; Knowledge Management and Communication; Global Standard (GS1) commencement; and LLIN mass distribution campaign.
GLOBAL HEALTH SECURITY AGENDA (GHSA)
USAID, together with other USG agencies, supports the GHSA, with the goal of preventing and combating emerging and re-emerging diseases of animal origin that have pandemic potential among humans. Working in cooperation with other USG agencies engaged in the National Security Council’s global health security agenda, USAID’s areas of concentration include: zoonotic disease interventions aimed at minimizing the spread of diseases from animals to humans, including interventions intended to improve social behaviors, policies, and practices; Antimicrobial Resistance (AMR) that addresses human, animal, agricultural, and environmental factors and the development of a national AMR strategic plan; strengthening surveillance and laboratory capacity; immunization programs aimed at strengthening the national vaccine system; and workforce development aimed at increasing an effective bio-surveillance workforce of clinical and community health providers.
COVID19 AMERICAN RESCUE PLAN ACT (ARPA)
Over the past nine months USAID/Liberia has planned USD$9,500,000 ARPA funds for Vaccine Readiness Support among multiple Implementing Partners. Over this same period the USG has donated over 1,500,000 doses of COVID vaccine to Liberia. USAID/Liberia is working closely with the Ministry of Health and other donors to support the rapid introduction and deployment of COVID-19 vaccines and to coordinate and support efforts to reach the Global goal of achieving 70% of the population vaccinated. Our strategy, in concert with partners, has prioritized 1) Coordination to facilitate the delivery of COVID-19 vaccines, 2) Pharmacovigilance and monitoring adverse events, 3) Training and supervision of surge and support staff, 5) Communication, Community Engagement, and Demand, and 6) health information systems.
