Save the Children has supported the Worhn community clinic in Gibi district, Margibi county, Liberia, since 1997.
With the aid of ECHO and then EU funding, we have financed the expansion of the clinic, built a maternal health centre and maternity waiting home; ensured the supply of drugs; trained staff and members of the community; provided furniture, medical equipment, mobile phones and motorbikes.
Save the Children also offers accommodation to vital health workers and pays the incentives for all 8 staff in the clinic. The Certified Midwife has just been informed that she is now on the government payroll but is yet to receive her first salary from the government.
This may be an early warning of bigger problems to come. The EU’s funding contribution will end in August. The only remaining funding is from the Capital Appeal, which can only be used to upgrade the building. The Worhn community clinic is yet to be classified as a district health centre but the planned upgrade will certainly ensure this.
Despite this, with the government taking over its day-to-day running from January 2014, the quality of services is in jeopardy. Among the Worhn community, there is a great deal of anxiety about the government’s capability: government-run health centres continue to remain inadequately staffed and under-resourced.
Amos Boyer, the Commissioner for Gibi district, was firm in assuring the community that the government will step up to the challenge but pleaded with Save the Children to “please leave small-small” – that is, gradually. Quite a sensible request, really.
But his request poses some real challenges. Will the system become strong if Save the Children continues to support health centres? Government and donor resources have been mobilised at both national and county level, so why is capacity still weak?
Political will needed
Liberia remains one of the most unsafe places to be a mother or new-born child. Government-run health centres remain inadequately staffed and under-resourced.
Political will has contributed to better policies but what is required urgently is a concerted effort: governments, donors and NGOs must harmonise plans, resources and development intent.
Until plans and resources are better streamlined to strengthen the health system and improve governance, it is the people of Liberia who will continue to pay the price.