Liberia: 'No One Should Suffer Hardship to Access Healthcare'

The Executive Director of Public Health Initiative Liberia (PHIL), Mrs. Joyce L. Jarwolo, has called for a healthcare system which would take into consideration access to health services for all irrespective of their financial status.

According to her, no one should suffer in their attempt to access better healthcare. Many women, she added, are still dying in childbirth, which is one of the natural processes in the health system.

Over the years, Liberia has made tremendous progress in the reduction of maternal and infant mortality rates, but UNICEF says Liberia is still one of the countries with the highest maternal mortality rates in the world.

In 2013, Liberia's maternal mortality rate dropped from 1,072 deaths per 100, 000 live births to 661 deaths per 100,000 live births in 2017. The infant mortality rate of deaths per 1,000 live births reduced from 69.19% in 2014 to 52.2 in 2017, according to Index Mundi.

Under-five mortality was also estimated at 94 per 1,000 live births (2013 DHS).

"One out of every 10 women dies while pregnant, giving birth to their babies or in the aftermath of delivery," recalled UNICEF, noting, "When a mother dies, the likelihood of her baby dying increases."

Therefore, Mrs. Jarwolo cautions that childbirth is a natural process and people should not see it as a death sentence. "Children who are dying on a daily basis are less than a year or 28 days old," she recalled.

UNICEF: "The mortality rate of newborns within the first 28 days of life, is also high -- 37 for every 1,000 live births."

Given these statistics, Mrs. Jarwolo said if the country cannot provide quality health care for its people, then it leaves the citizens with lots of questions, "because the problem is not about a shortage of drugs alone."

A few weeks ago, health workers staged a nationwide strike, abandoning their posts and patients for three days. The health workers, mainly those employed by the government, said although they swore a professional oath to save lives, it was unfair for the government to ignore their plights by not paying their salaries for well over three months.

In an unprecedented response to the health workers' strike action, a group of pregnant women took to the streets in Duport Road, Paynesville, and blocked the road because a nearby government-run clinic refused to provide services while the strike was being instituted.

Eventually, the government, through the Ministry of Health, reached an agreement with the health workers to return to work and that the payment of their salary arrears would be prioritized.

"There is a need for the government to invest in the health sector," Mrs. Jarwolo says.

She called on the government to put into place a national preventive program that will be cost-effective, as 35% of public health facilities go without drugs, adding: "With this picture, we cannot provide quality healthcare."

Due to this shortage, Mrs. Jarwolo added, "It is important for the government and all stakeholders to work out a cost-effective and sustainable way to finance health for all in Liberia within the context of leaving no one behind."

Mrs. Jarwolo also said that the "Revolving Drugs Fund (RDF) scheme" was introduced through a 4-day validation process, to reduce the chronic situation of essential drugs being out of stock at health facilities. This is a way to renew and strengthen trust in the health system.

The core idea of the RDF is to reduce the shortages of drugs and generate revenue to replenish supply.

For example, in Sudan, the RDF of the Ministry of Health in Khartoum State was implemented with financial support from Save the Children (United Kingdom), to improve chronic shortages of medicines in public health centres, according to Bull World Health Organ (Feb 2009).

This, Mrs. Jarwolo believes, will also bring redress to the public health system in Liberia, thereby providing essential and affordable drugs for everyone. Her vision is to see a well-functioning and responsive health system which the Liberian people will own and which can provide requisite programs to cater to the overall needs of the people.

"Our main focus in public health is prevention. It is something we are going to pilot and share our data with the government and other stakeholders to buy into that intervention," she said. She added that "One of our key issues is empowering the communities to save lives. Citizens can advocate for their own health, work to take action and make rational use of drugs instead of prescribing drugs for themselves."

PHIL, which has been in existence for over five years, is a community-focused public health organization which is working to promote and enhance the quality of healthcare delivery in Liberia, basically through leadership, partnership, innovation, capacity building and advocacy.

The organization is connected with various coordination mechanisms such as the Liberia Health CSOs Network. Together, they are pushing for access to quality health services for pregnant women, women in general and girls in the country.

Currently, PHIL has offices in Grand Bassa, River Cess, and Margibi counties, with headquarters in Montserrado County.

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