Liberia Health Systems Strengthening

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The development objective of the Health Systems Strengthening Project (HSSP) for Liberia is to improve the quality of maternal health, child health, and infectious disease services in selected secondary-level health facilities. This project has three components: The first component is strengthening the institutional capacity to improve the quality of selected health interventions at Performance-based Financing (PBF) health facilities. This component aims to support improvements to the quality of care related to maternal health, child health, and infectious disease interventions at selected hospitals in Liberia through the provision of performance-based incentives to support: (a) improved clinical practice; (b) adherence to well-established and defined clinical and treatment protocols; (c) health worker motivation (both intrinsic and extrinsic); (d) structural improvements (e.g. availability of drugs and commodities, and health facility rehabilitation); and, (e) improved management capacity, governance, monitoring and record keeping at health facilities. It has following two sub-components: (1) performance-based financing to address the systemic bottlenecks related to poor quality of care, and health system deficiencies; and (2) management and capacity building to provide intensive technical support to build the institutional capacity required to manage the PBF approach. The second component is improving health worker competencies to address key health-related concerns at selected health facilities. This component will complement efforts to improve the quality of care at target health facilities (discussed under first component), by improving the availability and competencies of health workers in these facilities, in critical specialist areas- obstetrics, pediatrics, general surgery and internal medicine. It has following two sub-components: (i) Graduate Medical Residency Program (GMRP) to support the design and implementation of a nationally accredited GMRP in defined critical specialist areas (obstetrics, surgery, pediatrics, and internal medicine, with a cross-cutting focus on anesthesiology); and (ii) in-service training programs to mid- level health cadres. This subcomponent will leverage the teaching capacity made available under subcomponent 2.i to provide specialized training in critical specialist areas to mid-level cadres (midwives, nurses, and Physician Assistant (PAs) in target hospitals as well as satellite health centers. The third component is project management. This component will support the operational capacity of the Ministry of Health and Social Welfare (MoHSW) to effectively manage the project. This will include support to the operational costs of a project- specific unit i.e. the HSSP coordination office- within the MoHSW that will be responsible for coordinating project activities.