Vertical interventions and system effects; have we learned anything from past experiences?

Charlotte Oliveira,Giuliano Russo

doi:10.11604/pamj.2015.21.262.6522

Abstract

The recent Ebola Virus Outbreak had a devastating effect on West Africa's already feeble national health systems. We suggest that such an impact turned out to be catastrophic because it hit particularly hard human resources for health and the delivery of primary healthcare services, which are cross-sectional to any health system. National and international interventions failed to understand the nature of this interaction, and concentrated on attending urgent specific vertical functions to fight the outbreak - the pillars - such as surveillance, logistics, safe burials etc. Such patchwork and vertical intervention strategy was always going to fail to tackle a system-wide problem, particularly in already fragile systems. We suggest that future interventions will have to learn from the experience of past initiatives for the introduction of HIV-AIDS services, which started as vertical programs and ended up including ever growing health system strengthening components.

Highlights

The recent Ebola Virus Outbreak had a devastating effect on West Africa's already feeble national health systems
We found Ebola Virus Disease (EVD) had an indirect effect on public health services such as on the reproductive health services of these countries, where quality services and skilled human resources were scaled down due to fear to deal with suspected Ebola cases in pregnant women [3]
We found that the international community unwillingly contributed to exacerbate the human resources for health shortage in ebola-affected countries; over the last year International and national NGO's started advertising ebola-related openings, offering different experiences and motivations to engage with the epidemic response - as well as sometimes higher salaries to attract local staff already willing to trade their ill-paid jobs at Ministry of Health (MoH) departments for an NGO experience

Summary

Introduction

The recent Ebola Virus Outbreak had a devastating effect on West Africa's already feeble national health systems. The EVD outbreak hit directly as well as indirectly primary health care services in all the countries.

Results

Conclusion