Rural Health Policy and Research


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WHO researches Tropical Disease in Liberia  
Written by Vivian Gartyn    
Tuesday, 28 October 2008 

The World Health Organization says it has launched the “phase three clinical trial” for Moxidectin in Tropical Disease Research in Liberia.

Moxidectin is being tested as an alternative effective drug for the treatment of river blindness.

River blindness is reported to be increasingly affecting people in the West African region.

According to WHO Country Representative Dr. Nesta, the goal of the research is to interrupt the transmission or eradicate the disease.

Dr. Nesta disclosed that a mini-research facility containing examination rooms and laboratories is nearing completion in Lofa County for the trial.

WHO is working along with the Liberia Institute for Biomedical Research and the Democratic Republic of Congo in the research.

On Monday, WHO donated three vehicles and equipment to LIBR exclusively for the research.

WHO also donated a consignment of assorted drugs and other equipment to the Ministry of Health to help improve the health care delivery system.  


Strike action hits international NGO  
Written by Robert J. Clarke, Jr.    
Tuesday, 21 October 2008 

Workers of the International Medical Corps have embarked on a strike action simultaneously in Monrovia and Lofa County in demand of benefits.

The IMC workers told Star Radio since they started working with the organization over four years ago management has failed to meet their needs.

The workers named medical, transportation, housing and severance benefits as some of their needs not being met by the IMC management.

The IMC workers represented by their spokespersons accused their management of ignoring their plights.

Mr. Stephen Zor and Darr Gbainmo said the strike action would continue until the IMC management meets their demands.

Our reporter who visited the IMC Head office in Monrovia saw no work being done as the workers were all sitting outside supinely.

In Lofa County, workers of the IMC abandoned their assignments, leaving health centers operated by the group in limbo.

When contacted, the Finance Manager of IMC, Briggs Kallon told our reporter the organization’s Country Director, Dr. Sham Alam was not prepared to talk to journalists. 


Growing Mental Health Needs, But Only One Doctor
UN Integrated Regional Information Networks
30 September 2008
Posted to the web 30 September 2008

Only five years out of a brutal 14-year-civil war that killed an estimated 150,000, according to the UN, and displaced and wounded tens of thousands more, Liberia only has one mental health specialist to treat trauma and depression. Health officials are preparing to meet on 2 October to find a way to treat the country’s growing mental health needs, despite the lack of trained doctors.

Bernice Dahn, the Ministry of Health director in charge of the Liberia’s health system and its employees told IRIN the country is ill-equipped to treat trauma, “To the best of my knowledge, there is one licensed doctor in the country to deal with post-traumatic stress disorder (PTSD). We actually do not have [enough] doctors to deal with this. There is one recognised health centre in [a community located on the outskirts of Monrovia] to deal with this problem.”

Mental health care ‘urgently needed’

Liberian fighters who were victims of sexual violence are more likely to report higher rates of depression, PTSD- a severe, ongoing emotional reaction to extreme trauma- and suicidal thoughts than non-combatants or former combatants who did not report experiencing sexual violence, according to a study published August 2008 in the Journal of American Medicine.

While this study focused on sexual violence against fighters, the UN has said civilians, especially women and girls, were subjected to multiple forms of sexual violence during Liberia’s civil war, including gang rape, sexual slavery, ‘survival’ sex in exchange for food, and unwanted pregnancies due to rape.

The Ministry of Health’s Dahn says health officials are drafting a national policy plan that will address mental health disorders among Liberians.

“We have now reached a decision to hold a national stakeholder meeting on 2 and 3 October 2008, at which time we will discuss with our local and international partners possible ways to deal with the issue [mental health needs] and put into place a policy working document,” Dahn told IRIN.

The health director told IRIN she expects to begin specialised training for doctors by December 2008, recognising the need to act as quickly as possible because of the increase of PTSD, especially among youths.

Jesse Plange with the non-profit, Liberia Emissary Anxious for Development (LEAD), which provides employment training to ex-combatants, told IRIN health officials need to pay more attention to youths’ mental health needs, especially those who took up arms.

In 2003, the UN estimated one out of every 10 children had been recruited to fight, or a total of about 21,000 child soldiers.

“Although our organisation has hired a counsellor to work with the ex-combatants, in most cases, we observe that they [still] behave abnormally. But we think the more they are kept in training and have a job to do, the more they will try to refrain from violence,” says Plange.

He said, unfortunately, his organisation’s programs are too short to keep ex-combatants in training for long while they undergo behaviour-change counselling.

“We have been finding [it] difficult to work with most of them [ex-combatants] in most instances because they behave abnormally, and sometime come out with unnecessary demands, such as demands for cash, that the organisation does not have the capacity to handle. And so, we are always careful when it comes to making promises because if promises are not kept, they get upset and may even go amok demanding their concerns be addressed.”

Ex-combatant Edward K. Teah, LEAD’s executive director, says the pressure of not being able to find work is too much for some former fighters to bear, “This has been the problem for most of us and in most cases, it adds to our frustration. Some think about [resorting] to violence again to make end meet.”

By August 2007, the UN reported about 90,000 former fighters, of which about 10 percent were children, registered into programs to help them find work and get used to civilian life once again. But the World Bank has estimated that more than three quarters of the population lives in US$1-a-day poverty, and more than 80 percent do not work in the fomal sector, if at all, rendering most reintegration efforts on the job front tough.

But there are ex-fighters who do not show any signs of trauma, says Francis Kollie, owner of an auto mechanic shop on the outskirts of Monrovia in the community Bushrod. He said his three former fighter employees trained at a vocational school founded by ex-combatants, Monrovia Vocational Training School (MVTC), and have adjusted well.

“We recruited the three ex-fighters after their graduation from the school [MVTC], but if you are not told that these boys are ex-fighters, you would not know because they have adjusted to the working conditions and feel that they are once again part of the society.”

[ This report does not necessarily reflect the views of the United Nations ]

Copyright © 2008 UN Integrated Regional Information Networks.

Story follows…

Key Survey of Nation’s Health Unveiled

19 September 2008
Posted to the web 19 September 2008
By Olubunmi Oloruntoba
Washington, DC

Liberia has taken another important step towards strengthening its nascent democracy by completing a nation-wide survey which provides a wide range of up-to-date information crucial to formulating good public health policies.

The Liberia Demographic and Health Survey (LDHS), unveiled in Washington, DC this week, provides data on fertility, family planning, childhood mortality, infant and child feeding practices, maternal and child health, maternal mortality, and HIV/AIDS-related knowledge and behavior, as well as HIV prevalence.

The results of the survey were presented by Tornorlah Varpilah, Liberia’s deputy health minister, and Anne Cross, the deputy director of survey operations for Macro International, a U.S.-based research organization, at the Woodrow Wilson International Center for Scholars.

Holding up the slim volume which the first such survey produced in 1986, Cross gave a visual demonstration of how much more comprehensive the new report is – it has produced a much thicker volume.

Varpilah, explaining the need for an up-to-date report, cited how he and his team were confronted by “contradictory statistics” when they had tried to draw up proposals for health funding from The Global Fund to Fight AIDS, Tuberculosis and Malaria.

For example, government agencies might give higher, and NGOs lower, figures for the Aids mortality rate – the reason being that high numbers painted a dire picture useful in soliciting funds from donors. Thus statistics were “a power game,” he claimed. “The more powerful you were, the more powerful were your statistics.”

Now, with the new survey – based on 2007 data – the ministry of health has the figures it needs to draw up its budget and to come up with realistic targets. The data also gives policymakers better insight into  what contributes to health threats such as respiratory infections, diarrhea and malaria, which Varpilah cited as the leading causes of infant mortality in Liberia.

On teenage pregnancy, the new LDHS tells us that nearly one in three women aged between 15 and 19 has already begun bearing children, and that young women with no education are more than three times as likely as those with secondary schooling to have started childbearing.

How does this finding relate to birth control? The survey also tells us that knowledge of contraceptive methods has increased dramatically in the past 20 years, with the number of women knowing at least one form of contraception rising from 72 to 87 percent between 1986 and 2007. Knowledge of male condoms has risen from 31 to 79 percent and of injectable contraceptives from 44 to 74 percent.

With such data, health researchers can now ask why the use of contraceptive pills has dropped from the six percent reflected in the 1999-2000 LDHS to four percent in 2007. A good guess, according to Anne Cross, may be that more women are now comfortable with injectables.

The new report is not without its critics. Hannah Guedenet, communications associate with Macro International, said the Liberian health ministry has contested findings on child vaccinations. The ministry estimated that as many as 85 percent of children of between 12 and 23 months had been vaccinated. But the study says that nationally only 39 percent have received all recommended vaccines – and that the figures in urban and rural areas respectively are 53 and 33 percent.

The most controversial parts of the report, however, have to do with the prevalence of HIV infection, which was measured by testing almost 12,000 men and women. The prevalence among adults aged between 15 and 49 was 1.5 percent – 1.8 percent for women and 1.2 percent for men – quite low compared to other African countries. The higher prevalence among women correlates with a finding that 10 percent of women reported that their first sexual intercourse was forced upon them against their will.

Anne Cross suggested there was a link between low prevalence of HIV and the finding that 98 of Liberian men are circumcised. Recent studies show that male circumcision reduces HIV infection. She also said the figures may reflect testing methods – normally researchers used rapid test methods, which gathered rates from urban health centers, while the LDHS interviewers used another testing method.

Varpilah also shed some light on the issue by noting that Liberia’s wars had immobilized many of its people, impeding the migratory patterns that have accelerated the spread of the virus in other parts of the continent. When a member of the audience pointed out similar trends in post-conflict societies such as Mozambique and Angola, Varpilah warned that “we cannot be complacent… The opening up of a post-conflict country can accelerate the spread of the HIV virus in a short time.”

A nationally-representative sample of 7,092 women and 6,009 men aged between 15 and 49 was interviewed for the LDHS. It is the third Demographic and Health Survey conducted in Liberia and was sponsored by the United States Agency for International Development (USAID) and the Liberia Institute of Statistics and Geo-Informational Services. Other sponsors include the United Nations Population Fund, the United Nations Children’s Fund and the UN Development Programme.
Copyright © 2008

Plan-Liberia graduates TBAs in Lofa  
Written by Wellington Geevon Smith    
Friday, 19 September 2008 

The Liberia branch of Plan International is today graduating thirty Traditional Birth Attendants in Voinjama, Lofa County.

The thirty TBAs are drawn from Kolahun, Vahun and Foyah Districts in the county.

Plan-Liberia conducted four months training for the TBAs to serve as traditional mid-wives in the north-western county.

The organization said it would provide tool-kits for the graduates to make in the rural communities more effective.

The training is part of a national Poverty Reduction Strategy program launched by government.

As implementing partner, Plan-Liberia, is to train five thousand Traditional Birth Attendants across the country by 2010. 


Jul 31, 2008

The Government of Liberia and its development partners have formally launched the 2007 Liberia Demographic and Health Survey (LDHS).

Vice President. Joseph Boakai. Wednesday, launched the report in the auditorium of the University of Liberia.

The survey was conducted in 2007 by the Liberia Institute of Statistics and Geo-information Services (LISGIS), Ministry of Health and the National Aids Control Program.

According to a LISGIS release, the LDHS 2007 report highlighted the current trend of the total fertility, child mortality and maternal rates and the current prevalence level of HIV/Aids in Liberia.

The project was funded by the Government of Liberia, in collaboration with USAID, UNFPA, UNICEF and UNDP.
Liberia Broadcasting System, ©2007

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