| PROGRAMMES: | | | LIBERIA | | |
  LIBERIA Background
After over 14 years of civil war and political instability, Liberia is rebuilding itself. With successful elections in October 2005 the country is now moving forward towards greater stability, reconciliation and restoration. Access across the country has improved and many families who were displaced during previous conflict periods are now returning home to their villages. |
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| Infrastructure and access to effective health-care services and schools remains generally poor throughout the country and even some services such as medicine, qualified staff and reconstruction interventions have not yet reached the most remote areas. The populations who live in these remote regions and many others now gradually returning, are amongst the most vulnerable in Liberia today. |
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The Crisis
Malaria is the primary cause of morbidity and mortality in Liberia and will remain so, until effective malaria control is sufficiently scaled up to cover these highly vulnerable communities. The disease is responsible for nearly 50% of all cases seen at health facilities. Data from the nation-wide household malaria survey show that 65% of children under five years have parasites in their blood, 80% of which have clinical signs/symptoms of malaria. |
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The MENTOR Initiative's response
Policy Change and Technical/Material Support
Since April 2003 The MENTOR Initiative has provided full-time technical field support and standardised technical guidelines and manuals for local and international partners to improve the design and quality of malaria interventions. One of the first tasks undertaken in April 2003 was supporting the MoH to reformulate the National Malaria Control Strategy and anti-malarial drug policy. The result allowed the immediate use of WHO recommended combination therapies. The MENTOR Initiative has supported the Global Fund mechanisms in Liberia in 2003, 2005 and 2006. Dovetailing the efforts of the Global Fund activities The MENTOR initiative has been able to supply agencies and communities with effective malaria case management and prevention tools. |
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Training
Training is carried out at county level and the courses include both training of trainers and direct training of health facility teams. The MENTOR Initiative, alongside the NMCP, has now trained the majority of NGO and MoH health workers in the new protocols for malaria case management. |
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Health Facility Coaching/In-House Support
The emphasis of MENTORs case management capacity building is to ensure the expansion of follow-up clinical coaching at health facility level, in order to reinforce and support health teams that have been trained in the new malaria protocols. Coaching is incorporated into monitoring activities and carried out with partner agencies and MoH county health teams as they undertake their routine supervision. |
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Malaria and Pregnancy
Great emphasis is placed on understanding, at community and health facility level, the complications of malaria in pregnancy and the need for effective malaria prevention during pregnancy. MENTOR encourages and supports partner agencies to provide and record complimentary malaria prevention education to pregnant women. |
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| This includes IPT delivery and distribution of longer lasting insecticide treated nets (LL ITNs). Coaching and supervision activities reinforce ANC delivery systems by tracking the availability of stock, tracking attendance rates, recording delivery rates of IPT and LL ITN and distinguishing and recording the number of times each woman receives IPT during the second and third trimester of her pregnancy. |
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Malaria Prevention
Insecticide treated nets (ITNs) and Indoor Residual Spraying (IRS) can both, if correctly used, achieve very high rates of protection from malaria for vulnerable families. The MENTOR Initiative continues to assist the NMCP and other partners to plan and implement the most appropriate and feasible prevention strategies for their programmes. Our teams help to monitor and record different strategies used by partner agencies. |
| In addition to supporting partners, The MENTOR Initiative carries out IRS campaigns with communities, to provide medium term protection from malaria amongst the most vulnerable communities who have recently returned to villages of origin. LL ITNs are provided through community and health facility distribution mechanisms. Agencies that are providing resources to ANC services and feeding centres are specifically targeted in order to reinforce messages about the prevention of malaria through delivery of tools and education. |
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Operational Research
In addition to the capacity building and training, The MENTOR Initiative’s focus is on operational research to help develop innovative and improved ways to prevent malaria morbidity and mortality. In partnership with the MoH, The MENTOR Initiative has carried out a variety of operational research projects including:
- ARGOS malaria surveillance project implemented at six sentinel sites;
- Testing of new prevention tools for acceptability and durability (Insecticide Treated Plastic Sheeting, Long-Lasting Insecticide Treated Nets and other materials);
- SP resistance;
- The use of Rectal Artesunate as a referral drug.
In addition, the acceptability, feasibility, and where possible, indicators of impact of malaria prevention and treatment tools supported in this programme are being assessed periodically through specifically designed surveys and health data monitoring. |
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The Future
The results of The MENTOR Initiative’s interventions in Liberia are increased access of the most vulnerable/at risk groups to effective treatment and prevention tools, an increase in capacity of health workers and facilities to provide effective malaria case management with adequate stocks, increased access to malaria prevention tools, improvement in the surveillance of malaria and expanding knowledge of current and future malaria control methods. |
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