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As the Covid 19 pandemic accelerates, how equipped is Liberia’s healthcare system?

By: Melvin B. Moore

Introduction

The coronavirus pandemic is still accelerating all over the world. 3.1 million Cases of infections have been reported globally. About 19% of all the infected persons have died worldwide.However, 3% of all the infected persons globally are still in serious or critical condition. The USA is the most hit with over 1 million infections and about 5.7% deaths resulting from coronavirus disease. This is according to worldmoeter statistics.

 In European countries, the highest number of coronavirus cases has been reported in Spain. However, it has less percentage of mortality, which stands at 10.2% compared to death in Italy, which is about 13.6%. The statistics are from john Hopkins University and worldmoeter. The statistics are changing every day, with an increasing number of new infections and deaths globally. In China, out of all those infected, 5.5% of them have died. About 8% are in serious or critical conditions, and approximately 92% are in mild condition. This is according to John Hopkins University statistics.

As of 28 April 2020, the number of coronavirus cases reported in Africa is 33,627 and still climbing, with a percentage of about 4.4% deaths around the continent. The most hit country by coronavirus pandemic in Africa is South Africa, with about 4,996 cases and with approximately 1.9% percent mortality of all the infected persons. In Liberia as of April 28, there are about 141 reported coronavirus infections about 16 deaths, which account for about 11.3% mortality of all the infected persons. This is according to the National Public Health Institute of Liberia

Global Overview of Healthcare System

Integrated Business Information System (IBISWorld), through its global research team, has tried to survey how healthcare systems around the globe are faring amid coronavirus pandemic. Also, it has decided to look at governments that are responding to the Covid 19 epidemic through healthcare support. Based on their survey, healthcare systems globally are undergoing different levels of strain with the increasing infection rates around the world. However, the governments around the globe have put robust responses with expectations of bolstering their healthcare systems to manage the pandemic. In Australia, for example, the epidemic has postured significant challenges to the healthcare system. IBISWorld report Q8511 indicates that the public hospitals in Australia with specialized ICU, which is a requirement for taking care of the Covid 19 patients who are in critical condition, are less than 20.0%. According to a survey by the Chinese center for disease control and prevention, the people who are aged 60 years and above are more significantly at risk. Therefore, with 21.4% of the population in Australia aged above 60-year-old, this poses a significant challenge to their health care system concerning coronavirus pandemic.

The IBISWorld estimates show that those aged 60 years and above accounts for 17.0% of the population in the USA. With the prevalence of the pandemic being high in the USA, the healthcare system has been highly strained. According to the American hospital association survey data of 2018 published in 2020, there are about 924,107 hospital beds capacity in the USA. The World Health Organization estimated that in 43 of the 55 countries in Africa, there were less than 5,000 intensive care beds per million people, compared with about 4,000 beds per million in Europe. The number of coronaviruses confirmed cases are above 1 million today. This indicates the Covid 19 pressure on the healthcare system.

State of Healthcare System in Liberia

According to the International peace institute report published in 2016, the healthcare system in Liberia was profoundly affected by the civil war. The medical equipment was looted, and many clinics were burnt down. Based on the World Health Organization data from Liberia, the country healthcare system was not adequate to handle Ebola in 2014 and 2015. They estimated that one doctor, as well as 27 nurses, were treating 100,000 persons.

The Service Availability and Readiness Assessment (SARA) survey 2018 on the healthcare system in Liberia found out that only 56% of health facilities were prepared to offer medical services based on the general guideline index by the ministry of health. This was in spite of the outline of the Essential Package of Health Services in the country (EPHS). In terms of the health system’s capacity, Liberia is among the least prepared countries to deal with the pandemic. Currently, more than 25 of the country’s over 35 confirmed cases of the Covid-19 positive patients are being treated at the 14 Military Hospital.

The Liberian National Development Plan for the year 2018 to 2023 noted that only 19% of health facilities in Liberia had essential health equipment. Also, the report revealed that the laboratory diagnostic capacity by the health facilities only performed 1 test out of 12. NDP also reveals that the health infrastructure per 10,000 people is only one (1) while the globally recommended standard is 2. The World Health Organization report on the Ebola situation shows that Liberia lost about 8% of doctors in the country, midwives, and nurses.  Based on Liberia Medical and Dental 2016 report, the country had a total of 298 medical doctors. This translates into 1:15,000 doctor per patient ratio for the 4.5 million population in the country. This is a low number of doctors compared to world health organization recommendation of 1:1000 doctors per patient’s ratio. The shortage of healthcare workers would remain a significant area of concern in the fight against COVID-19. The issue of not having enough qualified doctors, trained nurses, and supporting staff such as physiotherapists, ICU technicians etc. would severely undermine efforts to treat patients affected by COVID-19. However, with the collaboration of African Centers for Disease Control and World Health Organization, the Liberian government has mobilized precautionary measures.

There are isolation centers and training for healthcare personnel to hand the pandemic. Also, facilities for screening and diagnosis have been erected. Liberia has restricted flights and movements. People have been encouraged to wash their hands regularly with running water and soap as well as sanitizers. Officers of the Liberia National Police (LNP) are enforcing government’s mandate for residents to wear masks in public places. Programs are also being run to educate the masses through mass media, on coronavirus, how it is spread, and protective ways to use to avoid being infected. Nevertheless, despite all the efforts, the number of infections and deaths resulting from coronavirus pandemic is rising.

The IBISWorld survey on the impact of coronavirus pandemic on the healthcare systems indicates that there is inadequate medical equipment like ventilators to help critically ill Covid 19 patients. The World Health Organization reported that 41 African countries have less than 2,000 working ventilators to serve hundreds of millions of people in public hospitals compared with more than 160,000 in the United States. According to a report published by New York Times, at last count, Liberia had only six (6) working ventilators for 4.5 million people. Prior to Covid-19, the healthcare system in Liberia has been improving; the Covid 19 spread in the country has added more challenges to the healthcare system. There is a robust response by the Ministry of Health and all stakeholders. However, the increasing number of new cases and deaths from the Covid 19 pandemic is an indicator that measures put in place are not sufficient to handle the epidemic.

About the Author

Melvin B. Moore

Melvin B. Moore is a Liberian, Researcher and a Master of Public Health candidate with an emphasis in Monitoring and Evaluation at Mount Kenya University, Nairobi, Kenya. He served as National Volunteer during the Ebola virus outbreak (2014-2015) in Liberia. You can reach him on the following numbers: +254789355173, +254799869764 or via email: mooremelvinb@gmail.com

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