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Strengthening the Liberian Government’s Investment Program for Building a Resilient Health System

The German Federal Ministry for Economic Cooperation and Development allocated a grant of 15 million EURO to a new Health Program to be funded through KfW Development Bank. KfW contracted m4h to carry out the project identification and formulation exercise to define objectives, outcomes, and activities to be funded under the new program. During a two weeks period, in the beginning of June 2016, a team of partners and employees of m4h

– Prof. Michael Niechzial, Team leader and health service planner
– Dr Alain Yvorra, Biomedical engineer, and
– Mr Dominik Horrion, Peace and conflict analyst

and national experts

– Joyce Kilikpo Jarwolo, Public Health Expert,
– Garmondyu Zogar, Architect, and
– Nuaker Kwenah, Health Economist

conducted the field mission including meetings with the Ministry of Health

– Deputy Minister for Planning, Research and Development
– Head of the Infrastructure Department

and site visits to health facilities in four counties of the South-East region of the country. Those had been preselected by KfW and the MoH because of their needs in terms of health infrastructure development and the fact that so far they had not been benefitting from any other significant investment in the health sector.

On bumpy and sometimes very difficult roads the team travelled more than 1,000 km and identified 15 health facilities, from basic primary health centers to county hospitals that would benefit from the investment provided through KfW. Measures to be implemented in the framework of the new project will include rehabilitation, extension, and modernization of existing facilities and the new construction of two county hospitals where rehabilitation was not an option (based on a cost / efficiency evaluation). Staff housing and maternity homes shall help improving staff retention and accessibility to basic emergency obstetric care. In addition, the setting-up of sustainable systems for continuing maintenance of equipment, buildings, and installations, the management of solid waste and waste water, and the provision of utilities like potable water and electricity will be important components of the program.

Some accompanying measures (training, coaching) shall help improving management skills and quality of care supporting the staff that is working under hardship conditions in the sometimes very remotely located health care facilities. Based on their experience with the ongoing Reintegration and Recovery Program, that included a component to fight the Ebola epidemic Liberia went through in 2014/2015, the German NGO Agro Action (Welthungerhilfe) shall be contracted to manage the construction component of the program that will represent the biggest share of the budget, estimated at around 8.5 million EURO.

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