Africa

Liberia: Health Ministry Unable To Report All Deaths; Cites Limitations

Monrovia, Liberia – February 7, 2019: In the West African nation of Liberia, the reporting of deaths is woefully inadequate, in spite of the country’s Public Health Law which requires the registration of all deaths within 24 hours of occurrence. Severe under-development coupled with various factors have limited the ability of Liberia’s Ministry of Health to fulfill its mandate.

Ministry of Health Building

Ministry of Health Building

According to the Government Health Agency its Mandate include:

◾Formulation, Implementation, Monitoring and Evaluation of Health Policies, Plan, and Standards.

◾Deliver and Coordinate the Delivery of Decentralized Medical Care in Public Facilities.

◾Develop Health Manpower.

◾Undertake Preventive Services and Health Services, including Specific Health Interventions.

However, in a statement posted to its website, the Ministry, in trying to explain its inability to register all deaths in the country, stated that, “…This regulation has not been implemented to its fullest by the Ministry due to limited access to death registration services and information on the importance and need for death certification. As a result of inadequate access, the coverage of registration has always been below 5% annually. Apart from the mentioned plausible reasons for low registration of deaths, traditional and religious practices contribute to lower registration in Liberia. Death certificates are usually processed in Liberia with the intent to obtain insurance benefits, to settle inheritance issues and not as a requirement for burial and documentation of cause of death. The registration of deaths continues to fluctuate over the past seven years. In 2007, 548 deaths were registered compared to 624 in 2011 and 549 in 2012. In 2013, 659 deaths were registered compare to 600 in 2014.”

Vital Statistics require the accurate, complete and standardized reporting of births and deaths. The data collected from birth and death certificates and forms by the Liberian government is to be utilized for the identification, monitoring, informing and allocation of adequate budgetary resources to address public health issues. Data is also utilized in planning for the implementation and achievement of the Ministry’s vision of “A healthy population and social protection for all”.

Liberia Health Minister Dr. Wilhemina Jallah

Liberia Health Minister Dr. Wilhemina Jallah

With 14,916 Full Time Employees, the Health sector 2018/2019 budget is $81.7 million USD.

About $51.7 million USD account for employee compensation. In its budget narrative, the Health Ministry noted the following achievements for the past fiscal year and objectives for the current one.

Achievements (FY2017-18):

  1. Built adequate capacity for management of required medicines and supplies.
  2. Restored and enhanced service delivery systems to ensure a safe working environment and quality of care for clients to improve health outcomes.
  3. Established a functional emergency medical service including referral system between primary, secondary and tertiary care.
  4. Ensured adequate supply chain of medicines, Equipment and laboratory facilities in county hospitals, and
  5. Improved childhood preventable disease vaccination coverage.

 Objectives (FY2018-19):

  1. Build a fit for purpose productive and motivated health workforce that equitably and optimally delivers quality services

2. Expand capacity for leadership and governance to ensure that effective guidance of health actions is provided, and

  1. Support health professionals’ in-service training and career advances with an appropriate scheme of remuneration and benefits payment for healthcare workers based on performance and places of assignment.
Phebe Hospital - Bong County Liberia

Phebe Hospital – Bong County Liberia

In contradiction of these achievements listed in the 2017-2018 budget narrative, just three weeks ago, reliable reports surfaced that insufficient budgetary allotment for the smooth operation of the Phebe Hospital in Suakoko District, Bong County in central Liberia was causing problems.

Administrators at another government hospital in the southeastern political district of Grand Bassa County say the hospital is experiencing severe lack of essential drugs and fuel to operate. Major health centers operated by the Ministry of Health in Liberia continue to operate with meager budgetary resources and untrained personnel.

Liberia’s Health Minister Dr. Wilhelmina Jallah has admitted the shortage of essential drugs and resources for the smooth operation of medical facilities across the country but says her administration is seeking assistance from donors to address the deteriorating situation. She recently returned from assessment visits to medical centers in three political districts in western Liberia.

The 2014-106 Ebola pandemic laid bare the inadequate health system of the poor West African country. By April, 2016, when the pandemic was declared over by the World Health Organization (WHO), the U.S. based Centers for Disease Control (CDC) reported that Liberia accumulated 10,678 total Ebola cases and estimated 4,810 deaths.

Meantime, a signature project of Liberian President George M. Weah, the construction of a military hospital is ongoing.

Geographical Map of Liberia

Geographical Map of Liberia

The estimated cost of the facility is $3 million USD with an estimated completion date of late 2019. The cost is, however, expected to jump based on an increase in the price of materials. The project is in addition to the construction and relocation of the new Redemption Hospital in the western suburb of Caldwell, outside Monrovia. Unlike the Redemption Hospital for which an Environmental and Social Management Plan (ESMP) was generated and is posted on the website of the Ministry of Health, the 14 Military Hospital has no such plan.

The main objective of an ESMP is to provide measures to minimize adverse effects on the biophysical and socio-economic environment during construction and operation of such facilities.

Military 14 Hospital has no ESMP which would undertake the following:

1. field assessment of the construction site fto appreciate the magnitude of the project activities and determine their environmental and social footprint.

  1. review on the policies, regulations and environmental standards in order to develop a comprehensive and guided policy, legal and institutional framework so that the ESMP is responsive and aligned with government’s and financiers’ policies;
  2. discussion with major stakeholders including the Ministry of Health;

4. discussion with key informants from the surrounding communities, affected directly by the project;

  1. assessment of the socio-economic and the health-care systems data and prevailing national regulations, policies and standards; and
  2. verification that the project meets international standards.

By Our Health Reporter in Monrovia

West African Journal Magazine