Two Liberian experts have described the current healthcare state in the country is at a ‘collapse.’
The renowned global public health expert as well as the academician specializing in global security and economic development, Tolbert G. Nyenswah and Samuel Wai Johnson emphasized the urgent need for increased investments in healthcare to prevent further deterioration of the already fragile health system across the country.
They also argued that the staggering maternal mortality ratio (MMR) of 742 deaths per 100,000 live births far exceed the sub-Saharan Africa average of 542 – reflects profound deficiencies in the nation’s healthcare infrastructure.
Statically in Liberia, the healthcare system is faced with a severe crisis that is costing the lives of thousands of women and newborns each year across the country precisely in rural Liberia.
According to recent reports, approximately 1,100 women – equivalent to about three women every day and 8,100 newborns die annually in Liberia due to complications related to childbirth.
This alarming situation however underscores the urgent need for systemic reforms and international support to address the dire state of maternal and newborn health in the country.
The Director of the Department of Maternal, Newborn, Child, and Adolescent Health and Ageing at the World Health Organization, Anshu Banerjee, during a recent high-level meeting said, “The gravity of the situation, 1,100 women die every year in Liberia while giving birth should be a wake-up call to health authorities and the government of Liberia.”
This statement echoes the concerns raised by Dr. Nyenswah and Dr. Johnson, who emphasizes that these deaths are not just statistics but represents a failure of the system to provide adequate and equitable care.
In a detailed analysis by both Dr. Nyenswah and Dr. Johnson, they intoned, “If the 1,100 MMR figure mentioned by the UN H6 Joint Mission report is accurate, it indicates a significant increase, highlighting Liberia’s deficiencies in healthcare infrastructure, including inadequate access to skilled birth attendants and essential medical supplies.”
The 2019/2020 Liberia Demographic and Health Survey (LDHS) paints a grim picture, with newborn mortality rates standing at 36 deaths per 1,000 live births – alarmingly close to the regional average of 27.
The leading causes of maternal deaths include post-partum hemorrhage (PPH), which accounts for 38 percent of all maternal deaths, along with eclampsia, sepsis, and obstructed labor.
These conditions, largely preventable with timely and appropriate medical care, continue to claim lives due to the inadequacies of the healthcare system, as the analysis by Dr. Nyenswah and Dr. Johnson goes beyond the immediate causes of death to highlight broader systemic issues.
They point out that Liberia’s health system is not just failing at the point of care but is also hampered by socio-economic determinants such as extreme poverty, lack of education, inadequate access to clean water, and poor sanitation.
According to Dr. Nyenswah and Dr. Johnson, learning from successful interventions in other low- and middle-income countries, like Kenya’s expansion of family planning services has empowered women to make informed reproductive choices, while Bangladesh’s focus on ensuring skilled birth attendants at every delivery has significantly reduced maternal complications.
Ethiopia’s deployment of community health workers to provide care in rural areas and Rwanda’s investment in emergency obstetric care are other models that Liberia could emulate.
These initiatives, according to Dr. Nyenswah and Dr. Johnson, demonstrate that even in resource-constrained settings, targeted investments and strategic planning can yield significant improvements in maternal and newborn health outcomes.
However, the success of such interventions in Liberia hinges on adequate funding; a critical area where the country currently falls short and despite a recent increase in the health sector budget to US$80.1 million for Fiscal Year 2024, this amount is still far below the 15% target set by the Abuja Declaration for health sector spending.
Dr. Nyenswah and Dr. Johnson warned that without sufficient financial resources, the goal of reducing maternal and newborn deaths by half by 2030, as outlined in the Sustainable Development Goals (SDGs), will remain out of reach.
The Liberian experts underscore the importance of international aid, noting that the United States Government (USG), through agencies like the United States Agency for International Development (USAID), has been a significant contributor, providing nearly 35% of Liberia’s health expenditure through direct budget support and other initiatives.
Additional funding from bilateral donors, such as the European Union, Chinese Aid, Irish Aid, and multilateral organizations like the World Bank, the World Health Organization (WHO), and the Global Fund, also plays a crucial role in sustaining the healthcare system.
Meanwhile, to close this gap, the authors recommend revamping the Health Sector Coordinating Platform to better align donor resources with national priorities, and further called for engaging new players and donors to invest in healthcare innovations and research, particularly in developing a national insurance scheme that reduces out-of-pocket expenses for Liberians.
In their analysis, Dr. Nyenswah and Dr. Johnson offered several key recommendations to address the maternal and newborn health crisis in Liberia which include Increase Health Sector Funding and Strengthen Human Resources.
Others are to Upgrade Health Infrastructure, Enhance Community Health Programs and Establish Monitoring Systems, as the maternal and newborn health crisis in Liberia is not just a health issue, but a national imperative that demands immediate and sustained action.
As Dr. Nyenswah and Dr. Johnson rightly argued the future of Liberia’s women and children, and indeed the future of the nation, depends on the decisions made today, and the time to act is now, and the world is watching.
