PSI

Liberia is recovering from 14 years of a devastating civil war that crippled infrastructure, displaced much of the population and depleted resources. With a new government in place, headed by Africa’s first female president, a Poverty Reduction Strategy (PRS) was developed, which calls for the delivery of health and other basic services to the general population as tantamount to the nation’s recovery.

PSI/Liberia was founded in 2008 to work in partnership with the Ministry of Health and Social Welfare to implement the Basic Package of Health Service component of the National Health Plan. At the request of the government, PSI/Liberia’s first program focused on adolescent sexual and reproductive health, including HIV. In 2009, a child survival program was initiated. PSI/Liberia is also assisting in achieving the goals of the Poverty Reduction Strategy in the timeframe set.

PSI/Liberia works primarily in the capital city, Monrovia, where a third of the population lives. However, PSI products are available in other parts of the country, and in the coming years, will be followed with other program services.

The platform is staffed mainly by Liberians, some of whom have recently returned to the country to aid rebuilding.

Health Areas

Child Survival, HIV, Reproductive Health

Health Impact

PSI/Liberia estimates that in 2010, its products and services helped avert:

• 603 HIV & TB DALYs1
• 398 Reproductive Health DALYs
• 2,651 Child Survival DALYs
1. 1. Source: The DALY (Disability-Adjusted Life Year) is a widely-used, credible metric that was first developed by the World Bank and is now routinely relied upon in the public health community.

Health Interventions

• HIV Counseling and Testing

Improving Health in Liberia

Reproductive Health and HIV

One in three Liberian girls is pregnant by age 19, due to a high incidence of transactional/cross generational sex and lack of adequate information given appropriately to youth. As a result, PSI/Liberia initiated SmartChoice, a program for youth, encouraging smart choices on reproductive health issues.

The first component of the SmartChoice program is a half hour radio show hosted and developed by youth called “Let’s Talk About Sex” (LTAS). The show is aired twice a week on United Nations Mission in Liberia Radio (UNMIL), the UN peacekeeping mission’s broadcasting station with nationwide coverage, and at other times on smaller community radio stations. The radio show is also a community outreach tool using out-of-studio live shows, hype shows, listening events, newsletters and blogs. The hosts have gained prominence as effective sexual and reproductive health and HIV communicators and are often called upon to facilitate awareness sessions for various institutions.

The original hosts of the "Let's Talk About Sex" radio show

The community outreach aspect of the program is focused on the behavior change communication needs of specific target groups. With the launch of PSI/Liberia’s Star condoms, the outreach team holds “Star Nights,” promoting condom use at busy nightclubs. Some of the events are focused on commercial sex workers (CSWs), featuring peer educators who are themselves CSWs. The outreach team also has dedicated events for transport workers and petty traders.

iLead, another component of SmartChoice, will be launched soon. iLead aims to mentor and empower young women as iLEADers who will then spread the circle of empowerment to promote smart choices and decrease the lure of transactional and cross-generational sex.

A final component of SmartChoice will be the development of youth friendly reproductive health centers where young people can access information, services and products.

Safe Water and Child Survival

By one account Monrovia is the city with the second highest annual rainfall. Liberia’s rainy season, which runs from April to October, is accompanied by an increase in waterborne diseases such as cholera, typhoid, dysentery and other diarrheal diseases. Children under 5 are the most affected—one in five children does not reach his/her fifth birthday.

Pipe-borne water is available to only 25% of the population—up from 17% at the end of the war. As such, one of the goals of the PRS is to further improve access to 50% by 2011. Low technology point-of-use solutions provide an affordable interim way to increase access to safe water for the entire population whilst costly infrastructure is being built.

With funding from UNICEF, PSI studied household water treatment practices in Liberia and determined the most suitable dosage and formulation for using WaterGuard, which was officially launched in 2009 by Liberia’s president.

While local and international NGOs distribute samples to the most affected communities in Greater Monrovia and five rural counties during the rainy season, PSI distributes WaterGuard year round using local wholesaler and retailer networks.