Steps Taken to Maintain MNCH Services During the Ebola Virus Disease Outbreak in Liberia

Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

As in most emergency situations, the Ebola Virus Disease (EVD) outbreak severely impacted Maternal and Newborn health, reversing the gains that had been made in the past decade.

By November 17, 2014, the EVD outbreak in Liberia resulted in 7,082 cumulative cases and 2,974 deaths. In the same period, a total of 341 health workers were infected, with 170 deaths among the infected. Most health care workers (HCWs) who became infected with EVD are said to have contracted the disease while caring for pregnant women. As a result of these deaths, other HCWs panicked and abandoned their posts, creating closures of virtually all health facilities in the country. During the peak of the EVD outbreak, women were delivering in the street and many died alone with their unborn babies while in facilities that could accept them.

To mitigate the situation, we initiated an infection prevention and control (IPC) approach, which includes training of HCWs, provision of IPC supplies (including PPE, buckets, hand sanitizer, and chlorine), and supervision/mentoring to ensure adherence to IPC protocols.

In close collaboration with WHO, CDC and other partners, we assisted the MOH in developing a comprehensive standard operating procedure for IPC along with a training package known as “Keep Safe-Keep Serving”.

The aim of the approach was to interrupt EVD transmission and give HCWs confidence that they could continue to provide services while remaining safe. Within two months of implementing the approach, over 5,000 HCWs were trained in their respective work places. This measure enabled facilities to begin providing needed services safely to women, newborns, and other non-EVD patients.

At the same time, the USAID flagship project, implemented by the JSI-led RBHS project, refocused its resources and activities exclusively on the epidemic response, including partner coordination and communication, contact tracing and leading the National IPC task force.

Through these activities, JSI and other partners helped restore the provision of services to women and newborns.