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Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal.

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Presentation on theme: "Liberia Experience: National Level Coordination and Partnership in Cholera Control. 14-16 May 2008 Dakar, Senegal."— Presentation transcript:

1 Liberia Experience: National Level Coordination and Partnership in Cholera Control May 2008 Dakar, Senegal

2 Background Situation 15 counties and 88 districts Estimated 3 million people - Sparse Pop - density, 84 per sq mile except Monrovia (1 million people) -Infrastructures destroyed by war -Access to safe water - 24% (UNDP 2006), sanitation nationwide - 26% - (UNICEF, 2006) -Low households incomes. ¾ pop on less than US$1 a day (iPRS, 2007) -Infant mortality rate, 102/1000 & crude morality estimate 1.1/10,000/day (CFSN, 2006). -Diarrhea 2 nd cause in morbidity/mortality -Seasons– Wet –April – Oct, Dry Nov-March.

3 Cholera hot spot areas Occurrence (slides line graph) Sierra Leone Guinea Cote DIvoire Atlantic Ocean

4 Trends :


6 LIBERIA MAP SHOWING CHOLERA HOT SPOTS COUNTIES Lofa Nimba Bong Sinoe Gbarpolu Grand Gedeh Grand Bassa River Gee River Cess Grand Kru Bomi Margibi Grand Cape Mount Maryland Montserrado

7 National Strategy Coordination Partnership Surveillance / EWARNS Institutional capacity

8 Coordination Multisectoral approach Decentralized epidemic task force Standardized case management, surveillance & monitoring Partners mapping & up dates. Leadership – MOH/CHT Annual integrated plans. Pooled contingency plans / stocks

9 Partnerships Relevant GOL Ministries / Depts CBOs Hygiene behaviors promotion UN agencies: UNICEF, WHO, UNMIL - Tech. asst; Finance; Resources; logistics. Health/WATSAN NGOs and WATSAN CONSORTIUM Communities

10 Surveillance Standardized data collection tools & analysis at county levels. Pre-positioned investigation & case detection teams.

11 Institutional capacity INGO – (9), LNGO) (26) & CBOs in 4 counties UN agencies –(WHO, UNICEF, UNHCR) Community – ORT corners / Treatment centers, trained Trained staffs & community own resource persons (volunteers).

12 Successes Consistent reduction in attack rates Sustained multisectoral & integrated approach to cholera control Availability of trained local resources at community level. Sustained partners support. Decentralized chlorine stocks Response within 24hrs-48hrs Coherence approaches &Team work. Functional surveillance systems

13 OUR UNIQUE WAYS OF WORKING. Merged GOL coordination & WASH cluster. Innovations - Pooled funding (DFID/ECHO) -WASH consortium – 5 INGOs – services delivery & capacity building through GOL. - Pool funding from partners

14 Limitations/Challenges Deplorable infrastructure states High Poverty level Meager resources skewed towards curative services. Low WASH coverage. Insufficient resources – human & materials Weak national systems / policies enforcement. Inadequate mid-level skilled health personnel to manage cholera control Transition from humanitarian to development. Low access to health services Unreliable data for planning

15 LESSONS LEARNT Pre positioning of stocks - chlorine Routine Well chlorination. HH water chlorination practice Pre-mapping and identification of resources at county levels. Community based hygiene education ORT corners / Treatment centers Sustained partnership & coordination

16 Our Needs Long-term funding from donors, targeting AWD/Cholera / WASH. Support for Skill training on cholera management. Expansion of decentralized cholera confirmation laboratories - Counties Research on cholera to establish evidences for intervention. Support for sustainable WASH activities.

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