Strengthening health systems in Liberia: Prioritizing capacity building initiatives in three counties

Purpose: To prioritize capacity building interventions based on capacity assessment results for three County Health Teams in Liberia. Information Used: Results from capacity building prioritization exercises conducted after sharing capacity assessment results with County Health Teams from Bong, Lofa, and Nimba counties in Liberia. Methods: Capacity assessments based on the WHO Six Building Blocks of a Health System were conducted in three counties in early 2012. In the summer of 2012, results from these assessments were shared with the County Health Teams, and team members were asked to determine whether capacity building recommendations should be addressed in the short term (<6 months) or longer term (>6 months). Results: The lowest assessed building block for all counties was health systems financing. All three counties prioritized conducting monthly financial reviews of budget versus expenditures, and generating monthly financial reports. Other prioritized initiatives for all three counties in other building blocks included training supervisors to provide supportive supervision of staff, and training health facility staff to work with implementing partners (NGOs). Recommendations: While all counties performed similarly in many areas, there were unique circumstances that required different capacity building priorities for each county. Providing a system of capacity building that includes prioritizing initiatives can lead to sustainable systematic improvements for developing health systems. However, this process may require technical assistance from outside organizations that can objectively manage the capacity building process.