Partners In Health, Last Mile Health (Liberia) and Wellbody Alliance (Sierra Leone) have launched a coalition to scale-up rural Ebola response efforts and rebuild primary health systems in two of the most-affected countries: Liberia and Sierra Leone. The Coalition builds on over 40 years of collective experience (including 15 combined years in Liberia and Sierra Leone) in strengthening public health systems in partnership with Ministries of Health; and integrating research, teaching, and service to deliver high-quality, comprehensive health care to the poor.
The Coalition's strategy will be implemented across every level of care (community outreach, primary health facilities, referral centers and Ebola treatment units), and includes efforts to train health care providers, augment the clinical workforce and provide direct care delivery, reinforce and establish robust supply chain and logistics systems, provide technical assistance to Ministries of Health, and support the creation of best practices for a regional technical Ebola treatment and care task force convened by the World Bank.
The Coalition will partner with the Liberian and Sierra Leonean Ministries of Health to execute the project in three rural counties/districts: Grand Gedeh and Rivercess Counties in Liberia and Kono District in Sierra Leone, covering 1,000,000 people. Last Mile Health will serve as the lead implementing partner in Liberia, while Wellbody Alliance will serve as the lead implementing partner in Sierra Leone. The project focuses on the following objectives: 1) Train, equip and support 500 health workers across 47 primary health centers and establish one Ebola Treatment Center; 2) Train, equip and support 800 community health workers to carry out community-based education, prevention, surveillance, contact tracing and maintain essential health services in 500 villages; 3) Provide technical assistance to Ministries of Health at the national level to support the transition from Ebola response to health systems strengthening; 4) Support creation of and generate best practices for a regional technical Ebola task force convened by the World Bank.
Working in coalition will allow the partners to leverage local expertise, existing community-based networks, and robust experience in clinical and operational management to comprehensively respond to the outbreak and secure the best outcomes for the people in the communities the organizations served.
1) Train, equip and protect hundreds of rural health care workers and capacitate at least 20 local health clinics (September 2014 to March 2015)
2) Expand networks of community health workers (CHW) to increase active case finding, with training and support for at least 500 CHWs (October 2014 to May 2015)
3) Equip and staff a model, rural Ebola Treatment Unit in Grand Gedeh County, Liberia (October 2014 to March 2015)
These interventions will inform these broader Coalition efforts:
Provide technical assistance to Ministries of Health at national level to support transition from Ebola response to health systems strengthening by September 15, 2015.
Support creation of and generate best practices for a regional technical Ebola treatment and care task force created by the World Bank, by September 2015.
West Africa's Ebola outbreak continues to evolve in alarming ways, with Guinea, Liberia, and Sierra Leone struggling to control the escalating outbreak against a backdrop of severely compromised primary health systems and significant deficits in health worker capacity. As of September 14, 2014 over 5000 people have been infected, including over 240 health care workers, with over 2,500 deaths.
The current response faces major gaps. As highlighted in early September 2014 at the High-level Technical Meeting hosted by World Bank President Jim Yong Kim, key barriers include: scarcity of skilled health workers (e.g. 1-2 doctors per 100,000 people in Liberia and Sierra Leone); insufficient Ebola treatment centers; inadequate training of primary health care workers; and at the community level, inadequate surveillance, weak contact tracing (with loss to follow-up rates as high as 50%), and limited prevention and education outreach, especially in rural areas. Fighting Ebola requires a comprehensive strategy, from Ebola treatment in hospitals to revitalizing primary health care and community-based services, that could transform how the world responds to epidemics and rebuilds public health systems.
Controlling the outbreak and providing greatly-needed care and treatment for patients will require a comprehensive strategy that includes increasing community outreach, education, prevention, and active case-finding; strengthening primary health care delivery platforms; capacitating Ebola treatment units; contact tracing; training health providers; and integrating high-quality supply chain and logistics management protocols within service delivery platforms. This framework emphasizes the integration of an Ebola response into broader efforts to build up community health and primary care delivery platforms, strengthening public health systems to meet the health care needs of the population and effectively respond to emergency epidemics. Designing and implementing a robust response to this outbreak could transform how the world responds to epidemics and how such crises can be used to rebuild and strengthen public health systems
The Coalition, led by Partners In Health in collaboration with Last Mile Health and Wellbody Alliance, is seeking partners who wish to invest in the regional response to Ebola in West Africa from the village to the Ministry of Health level, with the ultimate goals of strengthening public health systems in Liberia and Sierra Leone, and proving what's possible in settings of poverty.