SOCIAL IMPACT LIBERIA, 2017 DESK REVIEW LIBERIA HEALTH AND WASH SECTOR September 2017 This publication was produced for review by the United States Agency for International Development / Liberia. It was prepared independently by Social Impact, Inc. DISCLAIMER: The author’s views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. CONTENTS I. Executive summary ........................................................................................................................................................ 5 Methods .......................................................................................................................................................................... 5 Key Findings ................................................................................................................................................................... 5 Recommendations ........................................................................................................................................................ 7 II. Introduction .................................................................................................................................................................. 11 Background ................................................................................................................................................................... 11 Objective of this Study .............................................................................................................................................. 11 III. Desk Review Approach ............................................................................................................................................ 11 Research Questions ................................................................................................................................................... 11 Methodology ................................................................................................................................................................ 12 IV. Desk Review Findings ............................................................................................................................................... 13 Question 1: What does existing information identify as major priority areas of intervention in Liberia’s Health and WASH Sectors? ..................................................................................................................................... 13 WASH ...................................................................................................................................................................... 13 Maternal and Child Health (and nutrition) ...................................................................................................... 14 Family Planning ....................................................................................................................................................... 15 Infectious Diseases ................................................................................................................................................ 16 Non-Communicable Diseases ............................................................................................................................ 18 Mental Health ......................................................................................................................................................... 19 Animal and Veterinary Health ............................................................................................................................ 19 Health Systems Strengthening ............................................................................................................................ 20 Question 2: What do relevant Government institutions identify as their priorities and has there been any progress in accomplishing their goals in the Health & WASH Sectors? ................................................ 21 WASH ...................................................................................................................................................................... 22 Maternal and Child Health (and nutrition) ...................................................................................................... 24 Family Planning ....................................................................................................................................................... 25 Infectious Disease .................................................................................................................................................. 26 Non-Communicable Diseases ............................................................................................................................ 27 Mental Health ......................................................................................................................................................... 27 Animal and Veterinary Health ............................................................................................................................ 28 Health Systems Strengthening ............................................................................................................................ 29 Question 3: Where are the gaps in the Health & WASH sectors and what are key opportunities for USAID investment? .................................................................................................................................................... 31 WASH ...................................................................................................................................................................... 31 1 Maternal and Child Health (and nutrition) ...................................................................................................... 32 Family Planning ...................................................................................................................................................... 33 Infectious Disease .................................................................................................................................................. 33 Non-Communicable Diseases ............................................................................................................................ 34 Mental Health ......................................................................................................................................................... 35 Animal and Veterinary Health ............................................................................................................................ 35 Health Systems Strengthening ............................................................................................................................ 36 V. Recommendations ...................................................................................................................................................... 37 Annex I – Statement of Work ...................................................................................................................................... 40 Annex II – Table of Existing Assessments, Reports and Surveys Post-2014 ..................................................... 42 Annex I1I – Annotated Bibliography ........................................................................................................................... 44 General Health ....................................................................................................................................................... 44 WASH ...................................................................................................................................................................... 44 Maternal and Child Health ................................................................................................................................... 46 Family Planning ....................................................................................................................................................... 47 Infectious Disease .................................................................................................................................................. 48 Noncommunicable Disease ................................................................................................................................. 49 Mental Health ......................................................................................................................................................... 50 Animal and Veterinary Health ............................................................................................................................ 51 Health System Strengthening .............................................................................................................................. 51 2 ACRONYMS Acronym Explanation ALMA African Leaders Malaria Alliance ACTs Artemisinin-based Combination Therapy ANC Ante Natal Check-up ARI Acute Respiratory Infection CDC Center for Disease Control CSW Commercial Sex Workers CHAI Clinton HIV/AIDS Initiative CHC Community Health Centers C-HMIS Community Health Management Information System CHDC Community Health Development Committee CHSD Community Health Services Department, Ministry of Health