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Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal

Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal. Background Situation. 15 counties and 88 districts Estimated 3 million people - Sparse Pop - density, 84 per sq mile except Monrovia (1 million people)

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Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal

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  1. Liberia Experience:National Level Coordination and Partnership in Cholera Control. 14-16 May 2008Dakar, Senegal

  2. Background Situation • 15 counties and 88 districts • Estimated 3 million people - Sparse Pop - density, 84 per sq mile except Monrovia (1 million people) • Infrastructures destroyed by war • Access to safe water - 24% (UNDP 2006), sanitation nationwide - 26% - (UNICEF, 2006) • Low households incomes. ¾ pop on less than US$1 a day (iPRS, 2007) • Infant mortality rate, 102/1000 & crude morality estimate 1.1/10,000/day (CFSN, 2006). • Diarrhea 2nd cause in morbidity/mortality • Seasons– Wet –April – Oct, Dry Nov-March.

  3. Cholera hot spot areas • Occurrence (slides line graph) Guinea Sierra Leone Cote D’Ivoire Atlantic Ocean

  4. Trends :2005 -2007

  5. Lofa Gbarpolu Grand Cape Mount Bong Nimba Bomi Margibi Montserrado Grand Bassa Grand Gedeh River Cess River Gee Sinoe Grand Kru Maryland LIBERIA MAP SHOWING CHOLERA HOT SPOTS COUNTIES

  6. National Strategy • Coordination • Partnership • Surveillance / EWARNS • Institutional capacity

  7. Coordination • Multisectoral approach • Decentralized epidemic task force • Standardized case management, surveillance & monitoring • Partners mapping & up dates. • Leadership – MOH/CHT • Annual integrated plans. • Pooled contingency plans / stocks

  8. Partnerships • Relevant GOL Ministries / Depts • CBOs Hygiene behaviors promotion • UN agencies: UNICEF, WHO, UNMIL - Tech. asst; Finance; Resources; logistics. • Health/WATSAN NGOs and WATSAN CONSORTIUM • Communities

  9. Surveillance • Standardized data collection tools & analysis at county levels. • Pre-positioned investigation & case detection teams.

  10. Institutional capacity • INGO – (9), LNGO) (26) & CBOs in 4 counties • UN agencies –(WHO, UNICEF, UNHCR) • Community – ORT corners / Treatment centers, trained • Trained staffs & community own resource persons (volunteers).

  11. Successes • Consistent reduction in attack rates • Sustained multisectoral & integrated approach to cholera control • Availability of trained local resources at community level. • Sustained partners support. • Decentralized chlorine stocks • Response within 24hrs-48hrs • Coherence approaches &Team work. • Functional surveillance systems

  12. OUR UNIQUE WAYS OF WORKING. • Merged GOL coordination & WASH cluster. • Innovations - Pooled funding (DFID/ECHO) -WASH consortium – 5 INGOs – services delivery & capacity building through GOL. - Pool funding from partners

  13. Limitations/Challenges • Deplorable infrastructure states • High Poverty level • Meager resources skewed towards curative services. • Low WASH coverage. • Insufficient resources – human & materials • Weak national systems / policies enforcement. • Inadequate mid-level skilled health personnel to manage cholera control • Transition from humanitarian to development. • Low access to health services • Unreliable data for planning

  14. LESSONS LEARNT • Pre positioning of stocks - chlorine • Routine Well chlorination. • HH water chlorination practice • Pre-mapping and identification of resources at county levels. • Community based hygiene education • ORT corners / Treatment centers • Sustained partnership & coordination

  15. Our Needs • Long-term funding from donors, targeting AWD/Cholera / WASH. • Support for Skill training on cholera management. • Expansion of decentralized cholera confirmation laboratories - Counties • Research on cholera to establish evidences for intervention. • Support for sustainable WASH activities.

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