SERVICE DELIVERY RE-IMAGINED

    Disrupting traditional service delivery models, with a focus on healthcare operations

    LIBERIA CASE STUDY
    Contracting with Private Providers 

    In Liberia, according to Ministry of Health guidelines, contracting with private healthcare providers is left to the discretion of County Health Teams. Yet experience with models to engage and accredit private providers through public financing is limited. This is despite the fact that more than half of Liberian health facilities are privately owned.

    Paying Out of Pocket for Private Care

    An Essential Package of Health Services are provided for all Liberians at no cost in public health facilities. However, this does not .... According to a 2012 USAID-supported assessment of the Liberian private health care sector, “the strengthening of [the] public sector and the provision of free care did not necessarily decrease the use of private sector use by the poor” (Health Systems 20/20). 

    Laying the Groundwork for Insurance

    In 2014, Liberia began to articulate its vision to advance UHC by establishing the Liberia Health Equity Fund (LHEF). The LHEF would improve financial access to care by laying the groundwork for a national health insurance scheme in Liberia. In the second half of 2014, the outbreak of Ebola Virus Disease (EVD) put these plans on hold. 

    Facing Vulnerabilities in the Sector

    During the height of the EVD crisis in Liberia, public health services were rendered dysfunctional and confidence in the public health sector plummeted. According to the Liberia Ebola Investment Plan for 2015 – 2021, the number of outpatient visits to public clinics declined by 61%, as Liberians sought care from private and informal sectors or avoided care altogether. Women and newborns were disproportionately affected with declines of 43% in antenatal care and 38% in institutional deliveries between August and December 2014 compared to the same period in 2013.

    Learning from the Ebola Crisis

    The Liberia Ebola Investment Plan for 2015 – 2021 states that “particular attention will be paid to government’s role in regulating the private sector health facilities to ensure quality standards are met” and to “focus on joint identification of the priorities that the private sector is best placed to support, agreement on collaboration modalities and clear performance frameworks.” Unpacking the feasibility of national health insurance concluded, including the government's capacity to deliver the “operational role” of a health insurer (e.g., collection of premiums, member management, and claims reimbursement) is under discussion. 

    Disrupting Care for Pregnant Women

    How can we expedite care for poor pregnant women, ensuring women and newborns can accessing both the public and private sectors to receive essential, quality care? See what we're proposing ...