|Lessons Learned||Way Forward|
|1. The 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system.||
• Fully implement the legal and administrative framework necessary for decentralization of the health sector;|
• Emphasize a Primary Health and Social Welfare Care approach that encompasses decentralization, community empowerment, and inclusive partnership; and
• Base resource allocation criteria on the services to be provided and the size, density, and geographic location of the catchment population.
|2. The innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy.||
• Establish a National Health and Social Welfare Financing Policy to build on the Health Sector Pool Fund experience; and|
• Progressively increase government contribution to the health and social welfare sector, towards its Abuja commitment of 15% of total government expenditures.
|3. A substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system.||
• Revise the National Strategy and Policy for Community Health to improve integration of Community Health Workers (CHWs) into all levels of the health system; and|
• Strongly consider paying CHWs, given the critical role they will be asked to play and the well-documented challenges of volunteerism.
|4. Effective strategies for HIV/AIDS care in other settings should be validated in Liberia and adapted for use in other chronic diseases.||
• Apply lessons learned from HIV/AIDS care to other chronic disease care (e.g., task-shifting, community-based care, reducing or eliminating out-of-pocket costs to patients); and|
• Test innovative methods to improve long-term retention in care (e.g., linking clinical and social services, adapting CHW home-based care to mental health disorders).
|5. Mental health disorders are extremely prevalent in Liberia and should remain a top chronic disease priority.||
• Continue to prioritize mental health in the 2011 National Health Policy and Plan; and|
• Implement basic mental health services at the health center and community level.
|6. Better information systems and data management are needed at all levels of the health system.||
• Implement a National Health Information System; and|
• Explore and deploy low-cost mobile technologies to improve community-based data collection and care delivery.