Health systems strengthening through responding to ebola virus disease: Staff, stuff, space and systems

In response to the overwhelming epidemic of ebola virus disease (EVD) in West Africa, the non-profit organization Partners In Health (PIH) engaged to deliver health services and strengthen the public health sector in Liberia and Sierra Leone in October 2014. With roots in long-term health system strengthening activities in countries such as Haiti, Rwanda, Lesotho and Malawi, PIH drew upon lessons learned from those experiences in planning the emergency response.

The principles of the PIH EVD response have been 1) acknowledging the role of weak health systems in the high case-fatality rate for EVD in West Africa. 2) supporting the governments and public sector, 3) maintaining flexibility to ensuring a nimble response to the changing dynamics of the epidemic, 4) having a health system strengthening approach from the first deployment of staff, 5) partnering with community health organizations that already had strong roots in affected communities.

Between November 2014 and February 11, 2015, PIH teams in Sierra Leone triaged 1526 patients at ebola treatment and care facilities, trained hundreds of national and transnational health workers, and equipped and supplied a dozen health facilities in both countries. As people infected with ebola virus have access to trained healthcare workers (staff), the required materials and supplies to diagnose and treat symptoms of disease (stuff), appropriate facilities with infection control procedures in place (space) and a functional health system in which to care for survivors and non-ebola cases, mortality and morbidity from EVD will decline.

We propose, as part of a panel of discussants that includes our community health partners Last Mile Health and Wellbody Alliance, and our supply partner Direct Relief, to discuss how the PIH approach to responding to the epidemic has improved case management in EVD, and improved access to basic non-ebola healthcare needs in the region.