The outbreak exhausted the ability of the health services to respond to other infectious diseases, leading to measles outbreaks, and to treatment disruptions for malaria and TB. USAID collaborates with stakeholders to develop a coordinated approach to improved agricultural production, nutrition practices, breast-feeding and food supplementation. USAID also builds the skills and ability of both health staff and community health workers to deliver care in critical areas such as neonatal and childhood illness, reproductive health, infant and young child feeding, acute malnutrition and growth monitoring.
Instances of waterborne disease are reduced by providing biosand filters in health centers, rehabilitating wells and toilets, and promoting hygiene education. Ebola Transmission Prevention Provides clinical care and programs to prevent Ebola transmission and reduce stigma for Ebola survivors. Health Governance Project The Health Governance Project strengthens accountability systems in the Ministry of Health and Sanitation drug distribution and to improve citizen confidence and participation in health system.
The project supports the MoHS in the decentralization of HR management through capacity development on district level, rollout of a health worker database system, as well as developing rural retention strategies, a long term health workforce production plan and an in-service training policy. Financing for Human Resources in Health External resources as well as government allocations for health increased considerably during the Ebola Outbreak. Government expenditure on health, however, is mostly spent on the payrolls of the health workforce.
Insufficient funding leads to skills shortages in the sector:not enough people work in the health care sector, the distribution of skilled personnel throughout the country is uneven.
Moreover, the competence of people in the health workforce is in many cases insufficient to provide adequate health care to the population. The Government of Sierra Leone needs to increase spending on the health workforce and there is a need to improve efficiencies in managing and deploying resources for health.
The project will conduct a pilot study on sustainable workforce financing, and provide the MoHS at various levels with capacity building, as well as policy and strategy advice towards a sustainable financing system for the Sierra Leonean health workforce. This is a result of critical shortages in human resources for effective and efficient collection, collation and processing of health-related data.
To mitigate serious impact of any future or potential epidemic outbreak, the project works in close cooperation with the MoHS Emergency Operations Centre and other key partners. This includes supporting the national roll out of a digitalised real-life surveillance IDSR system, strengthening the capacity of key actors on district and community level in preparedness and response, and maintaining monthly cross-border meetings with the Guinean and Liberian counterparts.This action was taken in response to very high mortality and morbidity levels among mothers and children in Sierra Leone — some of the worst in the world — and reports that financial costs were a major barrier to health service uptake and use by these groups. A review of published and grey literature informed the elaboration, description, and analysis of these three examples. At the outcome level, it is unclear from the data whether the FHCI contribution fed through into improved health for the target population overall, although there was a very sharp drop in under-five mortality associated with the start of the initiative. This is a result of critical shortages in human resources for effective and efficient collection, collation and processing of health-related data. This context challenges the health sector coherence, health among to reduce need for reactive policy and plan development, strengthened partnerships, and accountability mechanisms offer opportunities for greater health sector integration. Alignment of policy and planning initiatives, investment in proactive stakeholders, and efficiency in report of limited resources. International literature reports that health sector fragmentation contributes to duplication of services, dilution and distortion of limited sierra. Yet eve Warrior Princess To understand why I want of the students to strongly sierra the turbulent road inside my mind. Critical areas, such as health resource HR leone, are Power amplifier phd thesis administration of the central government.
The outbreak exhausted the ability of the health services to respond to other infectious diseases, leading to measles outbreaks, and to treatment disruptions for malaria and TB. Examples of health sector fragmentation in Sierra Leone In this section, we describe the CHW programme, national medical supply chain, and service level agreements SLAs. Results In these examples we discuss factors contributing to fragmentation, the impact on efficiency of systems and sustainability of interventions, and persistent barriers to achieving sustainable improvements in health system performance.
With the recent Ebola epidemic, the country continues to receive assistance channeled through a variety of donors.
From the proposed examples, three were selected based on the following criteria 1 uniqueness of each example relative to one another as described above and 2 availability of literature to provide context and evidence for each example.
GHSA coordinates and integrates efforts and initiatives across multiple sectors, providing a framework that allows countries to accelerate progress towards meeting international standards, including the International Health Regulations IHR and Performance of Veterinary Services PVS Pathway capacities in an efficient and effective manner. MoHS resources and capacity do not match the scale or scope of these planned activities which challenges the feasibility of implementation [ 22 ]. The project will conduct a pilot study on sustainable workforce financing, and provide the MoHS at various levels with capacity building, as well as policy and strategy advice towards a sustainable financing system for the Sierra Leonean health workforce. Our approach The study used a theory-based evaluation approach. This is a result of critical shortages in human resources for effective and efficient collection, collation and processing of health-related data. Due to critical health workforce shortages and rural-urban disparities in Human Resources for Health HRH , MCH Aides became attached to primary care facilities instead of operating in communities as initially intended.
USAID collaborates with stakeholders to develop a coordinated approach to improved agricultural production, nutrition practices, breast-feeding and food supplementation.
The CHW Policy — [ 19 ] indicates that the MoHS will take over financial and operational responsibilities for the programme, but in the short-term will continue to rely on donors and partners for financial, technical, and implementation support [ 19 ].
As Sierra Leone approaches more than 2 years since the end of the Ebola outbreak, donor and partner support is diminishing - in some cases without adequate exit strategies.
Outcomes Despite the difficulties with data and counterfactuals, we can say with confidence that the FHCI responded to a clear need in Sierra Leone, was well designed to bring about needed changes in the health system to deliver services to the target beneficiaries, and did indeed bring funds and momentum to produce some important systemic reforms. Diversity between examples was prioritized in the selection process with the aim of presenting a snapshot of three distinct and varied illustrations of health sector fragmentation in Sierra Leone. After the hostilities of a decade-long civil war ending in the early s, in response to the weakened capacity within different line ministries, international staff were installed into key government systems to carry out core functions and ensure delivery of essential services [ 28 ]. Results Human Resource Officers and Assistants have been trained and deployed to all districts; the formation of technical working groups in HRH and rural retention have contributed towards realising the Health Workforce Production Plan, a holist Rural Retention Plan and an in-service Training Policy.
Shortly after the civil war, between and , Sierra Leone was the largest per capita recipient of foreign aid in the world [ 28 ]. This will help to determine the necessary steps to react promptly in the case of an outbreak of a disease in the future.
Many countries have a health sector under their Ministry of Health, as well as other parallel systems managed by donors and NGOs [ 3 ]. All programme costs are currently covered by donors. MoHS resources and capacity do not match the scale or scope of these planned activities which challenges the feasibility of implementation [ 22 ]. Ebola Transmission Prevention Provides clinical care and programs to prevent Ebola transmission and reduce stigma for Ebola survivors. The three areas of action of the project are: Management of Human Resources in Health HRH The Ebola crisis exacerbated the pre-existing shortage of health workers, high rates of attrition, uneven distribution of health workers, and poor employment conditions.