Investing in Community Health Systems for Equitable Access to Services

Government Contact

Bentoe Tehoungue

Director of the Family Health Division, Ministry of Health and Social Welfare of Liberia

The Context 

Liberia aims to create a sustainable health financing system to guarantee equal access to quality healthcare and ensure financial protection for all. The government takes a phased approach to universal health coverage, focusing on incremental interventions toward domestic resource mobilization, pooling, and strategic purchasing. Some of these interventions are efficiency improvements, earmarked taxes, establishment of a joint coordination unit in the Ministry of Health, and—in the longer term—development of a national purchasing and pooling mechanism, the Liberia health Equity Fund, that merges risk pools, ensuring equitable access to quality health care for all Liberians.  

The GFF Partnership Response   

The GFF partnership contributes to the continuity and expansion of Liberia’s Community Health Assistance program to strengthen critical community health systems. The GFF supports implementation in three hard-to-reach South East counties (Grand Gedeh, Grand Kru, and River Gee) as well as in Gbarpolu and Grand Cape Mount counties. Three of these five counties (Grand Kru, Gbarpolu, and Sinoe) are priority counties from Liberia’s investment case. One of the key features of the GFF process is a focus on health financing reforms, including policy analysis to support the development of the Liberia Health Equity Fund (LHEF) - a multipronged health financing approach to achieving universal health coverage. The GFF-funded projects aim to support education and health systems to deliver sexual and reproductive health to young people, increase the knowledge and skills of adolescents on sexual and reproductive health; and create an enabling policy and program environment that promotes adolescent sexual and reproductive health and rights. In addition, results-based financing (RBF) is being implemented in hospitals to improve service quality.  

The Result 

The Community Health Assistance program showed notable results including an increase in the number of women referred to health facilities for deliveries, expansion of training for traditional midwives, and an increase number of women who delivered in health facilities from 33 percent in 2015 to 87 percent in December 2017. Postnatal care for newborns also increased from 15 percent in 2015 to 43 percent in 2017. With support from the GFF Trust Fund, Liberia expanded birth registration services to 14 hospitals in five counties and secured necessary equipment for processing. Between January and May 2019, almost 42,000 children were registered, 10 percent of them at the newly established registration centers within two months of operation. The performance-based financing program was also expanded to a total of eight counties and eight hospitals to improve the quantity and quality of health services, as well as strengthen decentralized management. In addition, the Sayana Press injectable contraceptive was introduced, the HPV vaccination was rolled out, and training and mentoring was conducted of health providers to offer comprehensive adolescent sexual and reproductive health and post-abortion care services, among other initiatives.  

More information on how Liberia achieved results are available on the latest GFF Annual Report.