Abstract
IntroductionIn August 2014, WHO declared that Ebola outbreak ravaging West Africa including Liberia had become a Public Health Emergency of International Concern (PHEIC). Infection prevention and control (IPC) among healthcare workers was pivotal in reducing healthcare worker infection and containing the recent EVD outbreak. Hard to reach areas (HTRA) presents peculiar challenges in public health emergencies. We present the result of IPC capacity building strategies deployed in Gbarpolu County: an HTRA of Liberia.MethodsBetween April to October 2015, we conducted IPC training and mentorship at the county, district and facility levels in a selected HTRA of Liberia using the keep Safe, Keep Serving manual and the WHO core components of infection control. Serial follow-up assessments and mentoring using the Liberian Minimum standard tool for safe care in Liberian health facilities (MST) were done.Results180 (100%) facility based healthcare workers were trained: including 59 clinicians (32%) and 121 (67%) non-clinicians. 100% of the healthcare workers in four selected very HTRAs were trained and underwent facility based-mentorship. Compliance with IPC practice increased: the MST score increased from 75% to 90% and for the MST score for waste management and isolation increased 60% to 87%.ConclusionStrengthening the capacity of healthcare workers for IPC was instrumental for containing the EVD epidemic but also critical for routine safe and quality services. A culture of IPC among healthcare workers in HTRA can be implemented through capacity building and training.
Highlights
In August 2014, WHO declared that Ebola outbreak ravaging West Africa including Liberia had become a Public Health Emergency of International Concern (PHEIC)
The Ebola Virus Disease outbreak in West Africa, was associated with 28,616 confirmed, probable and suspected cases reported in Guinea, Liberia, Sierra Leone with 11,310 deaths; Liberia had witnessed a total of 10,675 confirmed cases, 4,809 deaths including 378 health worker infections, 192 deaths of Liberian Health workers [4,5,6]
We focused on the County Infection prevention and control (IPC) focal person and selected members of the County Health Team (CHT) who were clinicians and had some oversight functions to the health facilities in the County
Summary
In August 2014, WHO declared that Ebola outbreak ravaging West Africa including Liberia had become a Public Health Emergency of International Concern (PHEIC). The Liberian EVD outbreak began in March 2013 in the forest regions of Lofa County and affected several parts of the country including remote and rural areas. Especially in large emergency operations like the EVD outbreak, are often constrained by geographical, physical, and other barriers, especially in very remote, isolated and hard-to-reach areas. Gbarpolu County is a landlocked area located in western Liberia; it shares a border directly with Sierra Leone, with Lofa County (which shares a border with Guinea), and Grand Cape Mount County These border connections have implications for epidemiology, disease prevention, and control. Some areas are encircled by rivers making access difficult during the rainy season This terrain often discourages many partners and health care workers to work in the County.
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