Submission ID 117010
| Issue/Objective | In Liberia, ownership of health interventions by key stakeholders has been a challenge and as a result, has led to the failure of critical health programs. In December 2020, the National AIDS and STI Control Program (NACP), introduced HIV/ Syphilis dual-tests as the first HIV screening test for pregnant women as part of the revised algorithm. As part of the policy, NACP developed a strategic guide emphasizing decentralizing dual-testing ownership to county and district health teams (DHTs). |
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| Methodology/Approach | The county health teams (CHT) selected lead trainers responsible for on-site training, mentorship, and supportive supervision. In Lofa County, the CHT decided to nominate its DHT to serve as master trainers to suit their county context. Master trainers were provided with a 3-day training and provided with a national training curriculum. Prior to the roll-out of HIV/Syphilis dual-tests in Foya district of Lofa County, the total number of pregnant women screened for syphilis during ANC was 324. Following the introduction of HIV/ syphilis dual-tests in April 2023, the total number of pregnant women screened for syphilis in DHIS2 was 2,649 (July- December 2023). |
| Results | During qualitative interviews in January of 2025, master trainers stated that "radio talk show made pregnant women rush to the hospital;" highlighting that the success of the intervention was due to the district team's innovation of engaging the community through media in local languages, radio talk shows, and leveraging key counseling messages from the curriculum. |
| Discussion/Conclusion | Empowering subnational health teams with skills, tools, and the flexibility to adapt services to their populations fosters innovation, high uptake, and long-term sustainability. As new interventions are introduced into the health system, it is critical to empower local CHTs and DHTs to have ownership and determine the best way to reach their populations and put local community at the forefront of any intervention. To achieve exceptional health outcomes, Liberia must engage sub-national teams while allowing flexibility for local innovations that enhance ownership. |
| Presenters and affiliations | Mildred Silikpoh Evidence Action William Zaza National AIDS & STI Control Program Elvina William National AIDS & STI Control Program Emilie Efronson Evidence Action |
