Liberia’s National Community Health Program has gradually advanced and made significant progress since the 2014 – 2015 Ebola Epidemic, when Liberia saw a complete breakdown in its healthcare delivery system, prompting the government to place the rebuilding of the health system at the top of its development agenda as is evidenced in the progress that has been made.
Based on the priorities outlined in the Post-Ebola Investment Plan for Building a Resilient Health System, the Government of Liberia set a roadmap to rebuilding a resilient health system to provide health security to all people, reduce risks due to epidemics and other health threats, accelerate progress towards universal health coverage, and the creation of a National CHA Program as part of a “fit for purpose” health workforce and contribution towards sustained community engagement. Thus, with support from partners, the Ministry of Health revised the National Community Health Services Policy for the period of 2016 – 2021. A key element of the Revised Policy was the institutionalization and integration of the National Community Health Program in Liberia’s health system.
This revised National Community Health Services Strategic Plan provided the framework needed to ensure the full implementation of the Policy and execution of identified activities under the Strategic Investment Areas in the Investment Plan, most notably Sustained Community Engagement and the fit-for-purpose, productive, and motivated health workforce with the goal to extend the reach of the country’s primary health care system through an integrated and standardized national Community Health Model that will provide a package of essential life-saving primary health care services and epidemic surveillance within communities and to households on an equitable basis.
Since its launch in 2016, our National Community Health Program has not only transformed our healthcare delivery system but also increased access to quality and affordable care to the doorsteps of our rural communities. Our Community Health Workers have conducted 8.9 million home visits including 551,951 pregnancy visits; treated 905,184 childhood cases of Malaria, Pneumonia, Diarrhea, and 1.2 million screening for Malnutrition cases; provided 446,388 women with access to family planning services, and refer over 355,000 pregnant women for Antenatal care and facility base delivery; and have identified and reported about 7,106 potential epidemic events excluding COVID-19.
Despite many health system challenges, the National Community Health Program has contributed to an increase in access to essential health services; as of December 2022, CHAs have increased equity in access to health services, reaching more than 70% of Liberia’s remote rural population of 1.5 million; 25% of all positive diagnoses of malaria by Rapid Diagnostic Tests are now done by CHAs at the community level since 2018; between 2018-2022, there was a 50% increase in confirmed malaria cases, highlighting the role of CHAs; as of December 2022, a total of 619,233 cases of malaria, 182,560 cases of pneumonia, and 122,110 cases of diarrhea were treated by CHAs, while 1,193,865 children under five have been screened for malnutrition and referred by CHAs. The current population served by our Community Health Workers is about 1.5 million of our nation’s rural population in 6,333 communities, 89 health districts in the 15 counties. As of January 2023, there are a total of 4,491 CHAs, 469 Community Health Services Supervisors and 5,060 Community Health Volunteers (Community Health Promoters – CHP); this is the largest grassroots employment of the government of Liberia.
Additionally, CHAs and their supervisors were already in place at the start of the COVID-19 pandemic and continued to provide essential services to their communities through detection, prevention and responding despite interruptions of services in most of our health facilities.
Given the immense gains made through our National Community Health Program, it is now a key pillar of the Liberian health care delivery system and a new ten-year National Community Health Policy (2023-2032) is poised to be launched during this 3rd International CHW Symposium. The vision of this new policy is to expand access and delivery of high-quality services to all communities through a government management community health workforce to contribute to the reduction of morbidity and mortality through the provision of a high-quality, cost-effective standardized essential package of community health services and to mitigate potential public health risks in all communities.
The Government of Liberia has taken the lead in driving the Community Health agenda on the African Continent and around the world by ensuring that it is well integrated into the larger healthcare system. To date, the Ministry of Health through its Community Health Services Division has remained focused in its engagement with the Africa Center for Disease Control Community Health initiatives in providing the needed technical assistance to some member states to expand Community Health Programs on the continent.
As a global exemplar, Liberia has demonstrated strong leadership; the leadership that enabled us to rise from the devastating effects of the Ebola outbreak, and the ongoing COVID-19 Pandemic. To share this success story, and launch our new ten years National Community Health Program Policy (2023 – 2032), and Strategy (2023 – 2027), Liberia bid in 2019 to host the 3rd International Community Health Workers Symposium and was awarded the bid by the Health System Global (HSG), Community Health Workers TWG, on June 29, 2020. This symposium is held every two years and is intended to provide an opportunity for advocacy for the host country and other nations for investment into its Community Health Program and the health system in general.
The theme of this third CHW Symposium is “Advancing Community Health Worker Programs to Build Resilient and Equitable Health Systems that Accelerate Primary Health Care for Universal Health Coverage”
The conference is expected to bring together 40 different countries from every region of the world with 600 delegates including high-level government officials from other nations, some UN Agencies, the Africa Center for Disease Control, development partners, Community Health Champions, Community Health Workers, Researchers, and foreign missions accredited to Liberia. The date of the 3rd CHW Symposium is March 20 – 24, 2023 with two days’ pre-conference and three days’ main event activities held at the EJS Inter-Ministerial Complex in Monrovia, Liberia.
This 3rd International CHW Symposium is critical and will be built on the Astana Declaration (2019), the African Union’s call for 2 million Community Health Workers (2020), the ongoing global conversation around Pandemic Preparedness and Response, the previous two CHW Symposia (Uganda 2017 and Bangladesh 2019), and the Institutionalizing Community Health Conferences (ICHC 2017, and 2021).
Participation in the symposium will be through a hybrid method; many of the participants will be by invitation while a considerable number of others will be by abstract applications. There will be two-day pre-conference activities centered around country engagement; creating the space for experience sharing and collaborations amongst the Community Health Roadmap Countries, the Global Fund NFM4 application engagement, and any partner who may want to have pre-conference meetings or workshops.
The approach to the main event will be guided by a global agenda that focuses on global best practices exchange, community health financing, CHW program institutionalization, and emerging evidence and innovations. There will be an opening ceremony and plenary session followed by a series of corresponding sessions of presentations, panel discussions, and plenaries as well as marketplaces for posters presentations, institutions engagement, sponsorship, and sales by accredited local vendors. The event will climax with a closing ceremony followed by an awards night for honoring key stakeholders and Community Health Workers from Liberia and other countries.