Strengthening health systems: What the Ebola outbreak is teaching us

Strengthening health systems: What the Ebola outbreak is teaching us

I am deeply concerned for the wellbeing of people in West Africa confronting the rapid spread of the Ebola virus. We wish to pay our respect to the courageous health workers battling the disease, and who have paid a disproportionate price for their heroism, as well as to the faith-based organizations that have remained on the front lines. We are now faced with a crisis of historic proportions that threatens not just the health of tens of thousands of people, but the economic and social stability of the region. On behalf of FHI 360, I want to express our deepest sympathy for all those affected by this scourge and our solidarity with our staff, counterparts, and colleagues in the affected countries.

This crisis will undoubtedly have broad consequences not only for West Africa, but for the wider world. If World Health Organization (WHO) officials are correct, the epidemic will take thousands more lives and we can expect an even deeper toll on already overwhelmed health systems. This is a crisis that requires the collective efforts of the international community.

The Ebola virus outbreak has exposed the fragility of health systems in poor countries—and shown how vulnerable nations are when basic social systems are unable to respond to critical needs. The world is now witnessing the terrible consequences of the failure to equip health systems, connect patients to direct medical care in rural areas, educate medical staff and the general population to risk factors and prevention methods, provide laboratory testing, and track disease surveillance data to monitor the spread of the virus.

By working to support WHO’s six building blocks of health systems, we can improve availability, use, and quality of health services delivered through both public and private facilities. We need to continue to develop and apply workable strategies to improve the quality of care and the performance of health systems, particularly in resource-constrained environments.

FHI 360’s work in health systems strengthening has taught us valuable lessons that cut across many sectors. We have learned that effective coverage of the population with essential reproductive health, family planning, malaria, tuberculosis, and maternal and child health services improves when these services are delivered in an integrated way with active community participation at the primary care level. Systems are stronger when performance-based training and supportive supervision are complemented with quality improvement and quality assurance processes at all levels—from nurses and physicians to laboratory staff and community health workers. A strong supply chain is critical to ensure that essential medicines and supplies are available. Working with local actors, including traditional healers, community health workers, and public and private medical professionals enables us to strengthen referral links between communities and health facilities, and reinforce community engagement in the design and operations of patient-centered approaches that maximize impact and resiliency. We are now witnessing the heartbreaking impact of not having durable public health systems in place in a region that is prey to transnational dangers.

Disease outbreaks, such as the horrific situation in Guinea, Sierra Leone, and Liberia force us to recognize the critical role of public health systems to securing national well-being and the catastrophic consequences if these services are overwhelmed. Impacted countries and those threatened by this unprecedented Ebola virus epidemic are doing what they can to shore up stressed health systems. The international community must support these efforts to ensure that people everywhere have access to health systems that they can turn to not only during a time of crisis, but also for routine health care.

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