The status of health services in the 15 counties of Liberia

Abstract

Aim: Liberia, situated at the West African coast, is composed of 15 counties with an economic gradient steeply decreasing from the Northwest to the Southeast. Health-related activities by government action in the 15 counties concentrate on the areas of family planning, antenatal and delivery care, as well as immunization, health workforce and infrastructure. The differences in this regard between the 15 Liberian counties will be reviewed.

Methods: A narrative review is employed, making use of the recent international and national documents, relevant literature and available information from the following primary and secondary sources and databases.

Results: The results point to gross differences between the 15 counties of Liberia in terms of health service provision. The overall readiness based on defined indicators for all 701 facilities was 59% with a range between facilities at the level of counties of 50% to 65%; for family planning services 88% (range 65% – 100%); for antenatal care 62% (range 55% – 100%); for immunization coverage 76% (range 66% – 86%). The health workforce of Liberia comprises 11.8 health workers per 10.000 population, WHO target is 23, the counties range from 8.0 to 15.7. Similarly, according to WHO standards, there should be 2 health facilities per 10.000 inhabitants, Liberia comes up to 1.9 however the counties range from 1.1 – 3.0 per 10.000.

Conclusions: It is obvious that across almost all areas of women and child health and health services in general there exist large differences between counties, which points to considerable health inequities in this country. The government of Liberia should consider reallocating the available resources per number of population instead of accepting historical developments, however with a correction factor in favou of disadvantaged regions and population groups.