The Ebola devastation of 2014-2015 in Liberia, Sierra Leone, and Guinea exposed the fragile health systems of the region. According to the US Center for Disease Control, over the period of the crisis, Liberia had 10,675 cases and reported about 4,809 deaths. Sierra Leone had over 14,124 cases and reported 3,956 deaths. Guinea had 3,805 cases and reported 2,536 deaths. Nigeria had 20 cases and reported 8 deaths.

The three countries most affected had come out of years of civil war. According to their national leaders, due to competing challenges in national rebuilding, the health care sectors had not received needed attention before Ebola arrived.

The weakened health systems are evidenced in the infiltration of Ebola. Cote D’Ivoire is bordered by Liberia on the west and Guinea on the east but they reported zero cases. There is certainly a reason why Nigeria, Africa’s most populous nation, and other countries in the region, were able to ward off the menace of the virus, though they were infiltrated by travelers from infected countries.

The World Health Organization states, “A well-functioning health system working in harmony is built on having trained and motivated health workers, a well-maintained infrastructure, and a reliable supply of medicines and technologies, backed by adequate funding, strong health plans, and evidence-based policies.” In 2007, WHO document Strengthening Health Systems to Improve Health Outcome, six building blocks of a health system were laid out:

Now that Ebola is over, it’s time for the Nations to pay serious attention to building a vibrant health care system. Health care is an essential and fundamental aspect of a nation’s building and an indispensable sector of any economy.

Currently, the average life span for Liberians is 61 years for men and 63 years for women, compared to over 75 years in countries with developed health care systems. Lives not fully lived can impact the workforce as it takes away training and experience, sometimes difficult to replace.

Generally, shorter life spans in populations can be indications of other health issues such as poor nutrition, which can lead to reduced immunity to fight off diseases, increased susceptibility to illness, poor physical and mental growth, and decrease productivity. No doubt, the wellbeing of a population cannot be overlooked. Not paying attention to the health of citizens is not only a health issue, it also is an economic issue.

Now that Ebola is over and the resilient population of Liberia has rebounded, what can we do to put the WHO’s building blocks in place? Our nation needs a strong health care system. The WHO health system framework has to be reached in order to achieve a fully functioning health care system, but for an emerging economy like ours, we have to identify where to begin. I recommend that we begin at the bottom with leadership or governance.

The WHO framework defines leadership and governance as ensuring strategic policies together with “effective oversight, coalition building, regulation, attention to system design and accountability.” Political will and commitment to building and strengthening the health sector cannot be understated. National leaders and health care officials have to provide the vision and leadership and pursue it relentlessly to ensure a better healthcare future for Liberians.

Next to leadership and governance is financing. Of course, it is cliché to say that without money nothing can be done. Financing, in this case, involves the availability of adequate funds for health care, to the extent that people are not impoverished due to the cost of healthcare for them and their loved ones. A strong health care system ensures that quality health care is available to citizens at affordable cost.

While governance, leadership and financing are fundamental building blocks, a health care workforce is indispensable to any health care system. It is well documented that Liberia has a serious deficit of health workers that have proper tools and resources to respond to any health situation that will arise in the country. An adequate workforce is one that is competent, responsive and fairly distributed throughout the country.

My organization, Chicago Global Health Alliance along with Education Systems Center at Northern Illinois University, or EdSystems, are committed to strengthening local health systems in Liberia. To this end, next month in April, we are organizing an awareness raising conference in collaboration with our partners and key stakeholders in Liberia.

The goal of the conference is to support stronger alignment of Liberian education and workforce training systems to long-term healthcare workforce needs. The conference will build on existing efforts by both organizations to support healthcare systems in Liberia. EdSystems has supported Career Pathways efforts, connecting education, training, and support strategies to enable individuals to secure relevant credentials and transition into a rewarding career. They have done this in partnership with the Liberian Government and public-private partners since 2013. Chicago Global Health Alliance has provided medical equipment, pro bono health services and trained health care professionals.

The conference will focus on five career pathways:

1) Health information management

2) Biomedical equipment technician certification

3) Community health

4) Nursing

5) Mental health

A secondary goal of the conference is to improve the coordination of existing efforts to build the Liberian healthcare systems. Attendees will be drawn from diverse sectors to enable idea exchange and increase cross-sector collaboration. Participants will include representatives from ministries of education and health, international and local NGOs, health care institutions, community-based organizations, 4-H programs, primary, secondary and post-secondary institutions, private-sector partners, and philanthropy. The conference will be designed to include a learning and action process for participants.

Conference Objectives

1) Develop a shared understanding of the key concepts of healthcare career pathways among conference participants

2) Build awareness and understanding of career pathways as a strategy to strengthen healthcare capacity

3) Lift up promising practices currently in use to bolster health career pathways in Illinois and Liberia with the goal of creating a community of practice that supports one another

4) Provide tools to enable participants to develop action plans tailored to the local context. Teams will be encouraged to use the tools to develop action plans that focus on the education pipeline and reflect strategies for integrating health career pathways at the primary, secondary and post-secondary levels.

5) Mobilize diverse stakeholders in Liberia who are committed to developing and/or expanding health career pathways.

We look forward to contributing to a strong Liberian health care system that produces better health outcome for the people of Liberia.

Featured photo courtesy of UNMEER