The Frontline Field Epidemiology Training Program in Liberia, 2015-2018

Abstract

Background: The Liberian Frontline Field Epidemiology Training Program (LFETP-F) was initiated by the Government of Liberia in 2015 in partnership with other organizations. Introduction of the program formed part of measures to improve integrated disease surveillance and response (IDSR) following the Ebola virus disease (EVD) outbreak in West Africa. We describe the establishment and implementation of the program, its outputs, and evaluated to determine whether it is meeting its objectives. Methods: We followed the logic model for the program to describe the inputs, activities, outputs, and evaluated the short term impact. We reviewed stakeholder meeting and training reports and interviewed a public health official to describe the establishment, implementation, and outputs of the training. We compared IDSR indicators before and after the inception of LFETP-F and described findings from a post-graduation assessment to determine the impact of the program. Results: Stakeholder discussions towards developing human resource capacity to meet Internal Health Regulations after the EVD outbreak led to the establishment of the LFETP-F in Liberia in 2015. From 2015 to 2018, 170 persons were trained in seven cohorts in Liberia. The district, county, and national level surveillance officers were trained in the basics of surveillance, outbreak investigation and scientific communication. Graduates are distributed all over the country, with at least one graduate in each of the 92 districts. Average post-test scores at the trainings showed improvement over pretest scores for each cohort. In 2018, among 20 outbreaks investigated and responded to by LFETP-F graduates, 90% were documented with investigation reports, compared to 53% in 2016; 78% were responded to within 48 hours compared to 37% in 2016. Conclusion: LFETP-F is fulfilling its mandate and meeting its objectives. Spread of diseases and deaths have likely been averted by the improved surveillance and response. A sustainability plan for funding and management of the program needs to be carefully developed by stakeholders to ensure that gains achieved over the first three years are not lost.