Improvement of health care for highly infectious diseases

Project description

Title: Improvement of health care through strengthening of epidemic prevention
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Liberia
Lead executing agency: Ministry of Health, Republic of Liberia
Overall term: 2016 to 2020

Context

The first case of Ebola Viral Disease in Liberia was diagnosed in March 2014. By the end of the outbreak, there were 10,672 reported cases of Ebola across the country, with 4,808 deaths, including 187 health care worker fatalities. The epidemic highlighted the fact that the Liberian system can guarantee neither reliable general basic health care nor resilience to health crises. Although there had been considerable progress since the end of the war in building a sustainable health system delivered by the Government of Liberia, the health system still faced a number of challenges when the outbreak occurred. Contributory factors to the severity of the outbreak included poor disease surveillance and data management, a lack of emergency preparedness on all levels of the system and poor clinical management of EVD patients.

The Government response was set out in the Health Investment Plan 2015 to 2021, aiming to ‘build back stronger’. Generating the potential to detect and appropriately respond to outbreaks of infectious diseases that could become epidemics is a key part of the Investment Plan. This applies not only to Ebola. This project will play an important role in building a health system which is resilient to health crises and which can detect outbreaks and respond effectively when the need arises.

Objective

The Government of Liberia can respond appropriately to epidemics and prevent them.

Approach

Working together with ministries, institutions and municipalities, the aim is to ensure an integrated response to emergencies. For example, the project works with the Ministry of Health (MoH) and the National Public Health Institute of Liberia (NPHIL) as well as with County Health Teams (notably Montserrado and the five counties of south-east Liberia) responsible for managing emergency preparedness and response. In the municipalities, the project supports health facility management and staff responsible for safe, high quality care, as well as members of the communities.

The project increases the capacity of isolation units which are integrated within existing hospitals (integrated severe infectious treatment units, inSITU). Renovating such units and making them fit for purpose allows them to provide high quality care for infectious diseases. This work focuses on key health facilities in Montserrado County, mainly Redemption Hospital in Monrovia, as well as Fish Town Hospital in River Gee County.

In addition, the project works with clinical and nursing staff at various facilities on improving functional, human resources, material and organisational processes, improving the quality of care provided to patients admitted to the isolation units and building high standards of infection prevention and control in order to protect staff, patients and the wider community.

It also works with MoH and NPHIL on developing national standards and clinical guidelines for the treatment of such conditions.

The project also supports the partners with implementing effective infection prevention and control activities in the isolation facilities and in the hospitals they are attached to.

The project tests the compliance with routine systems put in place to detect and respond to infectious diseases at national, county and facility level through simulation exercises and with the provision of appropriate technical and organisational advice.

These activities ensure that the community remains fully engaged and feels confident in both reporting incidents of highly infectious diseases for surveillance purposes and in seeking treatment in case of an outbreak of an infectious disease.

Results

To date, 75 staff members at the two cooperation facilities have been trained on infection prevention and control guidelines.

At one hospital, the incinerator and autoclave (lockable pressure tank) as well as the waste zone have been rehabilitated. The other hospital has been equipped with medical and laboratory devices as well as necessary consumables. Additionally, guidelines on health care waste management have been introduced at both hospitals. These measures enhance the provision of high quality of care and ensure staff safety.