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A ROADMAP TOWARD UNIVERSAL HEALTH COVERAGE Strategic Plan FY2018-FY2022 1 5 6 9 12 14 10 2 CONTENTS EXECUTIVE SUMMARY 5 PARTNERS IN HEALTH AROUND THE WORLD 6 PARTNERS IN HEALTH IN LIBERIA 8 OUR STRATEGIC PRIORITIES 11 ESTABLISHING A MODEL COUNTY FOR UNIVERSAL HEALTH COVERAGE 13 Programming Outlook 16 REINFORCING REGIONAL READINESS AND LEADERSHIP 21 Programming Outlook 23 TRANSLATING EVIDENCE INTO POLICY & ACTION 24 Programming Outlook 28 INVESTING IN THE NEXT GENERATION 29 Programming Outlook 33 REFERENCES AND DATA SOURCES 36 Opposite page: 1) Newly renovated ward for drug-resistant tuberculosis at JJ Dossen (Ezra Lugemwa / PIH); 2) PIH and the CHT visit Putu Pennoken facility in Grand Gedeh (Franciscka Lucien / PIH); 3) Surgery in the OR at JJ Dossen Hospital (Kyle Daniels / PIH); 4) Staff work in the renovated lab space at JJ Dossen (PIH); 5) Clinical staff at JJ Dossen Hospital (Rebecca Rollins / PIH); 6) A patient speaks with a provider at Pleebo Health Center (Rebecca Rollins / PIH); 7) X-ray services available to JJ Dossen for the first time in over 30 years (Jessica Farley / PIH); 8) Delivery of commodities to Janzon facility in Grand Gedeh (Franciscka Lucien / PIH); 9) Mental health consultation room at JJ Dossen Hospital (Jessica Farley / PIH); 10) Staff at the dispensary at Pleebo Health Center (Rebecca Rollins / PIH); 11) Construction underway for the expansion of Pleebo Health Center (Victoria Chan / PIH); 12) G Man of the County Health Team leads the way to Little Wlebo (Aubrey Davis/PIH); 13) Lab and biomed technician mentorship at F.J. Grante Hospital in Sinoe County (PIH); 14) NCD Clinic at JJ Dossen (Jessica Farley / PIH) A ROADMAP TO UNIVERSAL HEALTH COVERAGE | STRATEGIC PLAN FY2018-FY2022 | SECTION 1 “The effective delivery of quality health care to the poor requires dedicated partnership, the cultivation of hope and optimism, and a steadfast commitment to alleviating the suffering of others.” —DR. PAUL FARMER, CO-FOUNDER OF PIH Candace Harmon, a midwife at Glorfaken Clinic in Barrobo, on her way to a midwife training (Stephanie Chang/PIH). 4 PIH’s global network. The strategy is underpinned by PIH and the Liberian EXECUTIVE SUMMARY MoH’s shared belief in health as a human right, equity, accountability, transparency, decentralization, and partnership. It is aligned to global, regional and national frameworks and reflects the ways we believe we Partners In Health (PIH) exists to provide a preferential can add value to the MoH’s goal of building a resilient and equitable option for the poor in healthcare by accompanying local health system. and national governments in building delivery systems that increase healthcare access, utilization, and quality for all PIH Liberia will focus on four strategic priorities: those who need it most. 1. ESTABLISHING A MODEL COUNTY FOR UNIVERSAL HEALTH In September 2014, at the invitation of the Liberian government, the COVERAGE: building an integrated health care platform in Maryland World Bank, and the U.S. government, PIH joined in the international County that is equipped to deliver dignified, person-centered care; effort to respond to the Ebola outbreak. We are now transitioning from Ebola response to supporting the Liberian Ministry of Health (MoH) in 2. REINFORCING REGIONAL READINESS & LEADERSHIP: leveraging restoring essential services and building a resilient health system. Our a hub and spoke model that encourages strong County leadership and work is focused in Liberia’s rural Southeast region, where we aim to referral networks in the Southeast; establish Maryland County as a model county for innovative rural health 3. TRANSLATING EVIDENCE INTO POLICY & ACTION: supporting service delivery and Universal Health Coverage (UHC). Our commitment the MoH to design policies and programs, mobilize resources, realize to building a health care platform that delivers comprehensive services its vision for a resilient health system, and use the model of Liberia to and addresses the root causes of disease—by prioritizing the 5S’s: staff, advocate for global UHC; and stuff, space, system and social assistance—distinguishes our approach. 4. INVESTING IN THE NEXT GENERATION: cultivating Liberia’s next We know that improving health system performance and health generation of health leaders through medical education and workforce outcomes for all Liberians will only be possible with strong national training in program management and the science of global health delivery. plans, and we work to accompany the Liberian MoH in designing policies and programs, coordinating health financing, building a health workforce, The time is right to articulate a bold, new strategy for our work. We are and mobilizing resources. All of our work is guided by an understanding excited to embark on this journey with our patients, MoH visionaries, and of the burden of disease and a knowledge of the gaps, and draws on the partners. As Dr. Paul Farmer explains, “To accompany someone is to go expertise of those who face illness and poverty. somewhere with him or her, to break bread together, to be present on a journey with a beginning and an end. Accompaniment is much more often This document outlines our five-year strategy for accompanying the about sticking with a task until it’s deemed completed by the person or MoH, strengthening service delivery systems, and improving quality of people being accompanied, rather than by the accompagnateur.” This healthcare in Liberia. This strategic plan is the result of a participatory strategic plan covers the period 2018-2022, but our commitment to planning process that included national staff, partners, and experts from Liberia is long-term and we will stay until the work is done. 5 A ROADMAP TO UNIVERSAL HEALTH COVERAGE | STRATEGIC PLAN FY2018-FY2022 6 PARTNERS IN HEALTH Dr. Paul Farmer, as part of the PIH advance Partners In Health is a social justice organization Ebola Response team in committed to working alongside the communities it September 2014, waits serves to establish meaningful local partnerships and to board a UN flight to build delivery systems that increase healthcare access, Harper. (Source | PIH) utilization and quality for all. PIH prioritizes programming that tackles the root causes of poverty and disease in rural, underserved populations. It believes that taking a rights-based approach to health systems strengthening is key to achieving UHC. PIH BELIEVES A RIGHTS-BASED APPROACH TO HEALTH SYSTEMS STRENGTHENING IS KEY TO PIH endorses the principle of public sector accompaniment – it works at the invitation of ACHIEVING UNIVERSAL HEALTH COVERAGE. governments to strengthen local capacity through training, service delivery, research, strategy development and policy formulation. PIH contributes to building stronger care. To promote UHC, PIH uses an innovative forecasting tool (known communities through job creation and the reduction of catastrophic as the PIH-UHC matrix) that takes the population living within a clinic’s expenditures by bringing access to quality care to those who need catchment area, the known or estimated burden of disease of that it the most. Over the past thirty years, and across more than ten population, and existing clinic operations to make decisions about countries, PIH has developed a rural healthcare delivery model the allocation of resources. It then links these benchmarks with the that links community- and facility-based care. Its team of global staffing and infrastructure required to achieve UHC and improve health practitioners supports the translation of effective clinical services, outcomes with emphasis on the diseases that contribute to the highest policies, evidence-based programs and curricula across geographies. levels of morbidity and mortality. To respond to critical staff shortages and promote continued PIH has demonstrated what is possible but continues to innovate and innovations in people-centered care, PIH invests in capacity building generate evidence of “what works” in health system strengthening, of the local health workforce at all levels. To achieve the integration CHW networks, non-communicable diseases and injuries (NCDI), and decentralization of services, PIH trains and employs more than reproductive, maternal, newborn, child, and adolescent health, HIV and 12,000 community health workers (CHWs) worldwide. CHWs serve MDR-TB policy and programming. PIH is a trusted partner to Ministries as a bridge between community- and facility-based care teams, of Health and is asked to provide technical assistance as they build ensuring that healthcare services are responsive to patients’ needs, comprehensive healthcare delivery platforms, formulate national improve their health literacy, self-efficacy, access to and retention in policies, and institutionalize systems change. 7 A ROADMAP TO UNIVERSAL HEALTH COVERAGE | STRATEGIC PLAN FY2018-FY2022 PARTNERS IN HEALTH IN LIBERIA Liberia is in West Africa and spans 43,000 square miles. It is divided government, PIH joined in the international effort to respond to the into 15 counties and 136 districts, with an estimated population of more Ebola outbreak, providing accompaniment in response preparedness than 4.5 million. The average life expectancy is 64.7 years with a mean and infection prevention and control in Liberia’s Southeast region. age of 18 years (CIA World Factbook, 2015). In 2019, Liberia ranked 176 out of 189 countries in the Human Development Index and 155 out of In the aftermath of the Ebola outbreak, to address the health system needs laid bare by the
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