Government Of Health Systems : Liberia And Sierra Leone

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I. Background In recent years, Liberia, Guinea, and Sierra Leone have launched major healthcare initiatives in order to expand and improve access to services. However, the state of health systems for the last 20 years is difficult to overcome. Liberia and Sierra Leone were each embroiled in civil wars until the mid-2000s. Porous borders and a shared diamond belt meant that their conflicts were often shared, as political strife, violence, looting, armed forces, and refugees moved to neighboring countries. , Guinea in particular was on the receiving end of refugees. During that time in all three countries, health systems were uniformly poor, with under-staffed and under-resourced facilities, significant health disparities, and almost no systematic infectious disease surveillance or control. The formal end of the conflicts in the mid-2000s allowed increased political will for investment in health systems. The Basic Package of Health Services (BPHS) in Liberia and the Free Health Care Initiative (FHCI) in Sierra Leone initiated a slow improvement in health indicators. Then, in early 2014, the Ebola virus crossed the border from Guinea into Liberia and Sierra Leone, producing the worst Ebola epidemic in history. Despite modest health improvements in the decade or so following the end of active conflict, the 2014-2015 Ebola epidemic revealed ongoing systemic issues. The global involvement in the Mano River region countries, and particularly the role of the World Health

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