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Evaluation of the International Health Regulations core capacities at designated points of entry in Liberia, December 2019
Abstract
Introduction: In 2014, Ebola Virus Disease (EVD) outbreak struck West Africa, leaving Liberia as the most affected nation. Two years later, a Joint External Evaluation (JEE) conducted in Liberia revealed gaps within the disease surveillance system. These gaps existed due to limited implementation of the International Health Regulation (IHR) 2005 which was adopted by Liberia in 2007. The IHR 2005 is a legally binding document which guides nations to ensure global public health security, with the establishment of minimum core capacities at ports of entry (PoEs) as a requirement to reduce the risk of disease spread. We evaluated the core capacities at eight designated ports of entry in Liberia to assess the implementation of the IHR 2005, measure progress, and set benchmarks for future interventions.
Methods: A descriptive cross-sectional study was employed to evaluate the designated PoEs using the WHO PoE assessment checklist. The capacities assessed included vector control, cross-border coordination, quarantine, handwashing, communication, mobility, electricity, portable nearby water sources, and a trained workforce. Key informant interviews, document reviews, and direct observations at PoEs were also conducted. The result of the assessment was summarized in proportions and charts. Thematic analysis of the key informant interviews was also carried out.
Results: All the eight PoEs assessed had electricity and workforce trained on IHR. Cross-border meetings and information sharing were held with neighbouring countries in two-thirds of the PoEs assessed. The majority (7/8) of the PoEs had a portable water source, however handwashing facilities were only available in three. Similarly, only one had communication equipment, two had vector control mechanisms in place, and two had quarantine space for suspected ill travelers. None of the PoEs had functional transportation services to move sick passengers to the designated treatment facilities.
Conclusion: Core capacities at the study PoEs are partially established and there is a need to strengthen infrastructural, human resource, surveillance and response communication, and vector control capacities.
