Analysis of the post-Ebola recovery period of Sierra Leone and Liberia with lessons for future health emergencies

1. After the Outbreak
Analysis of the post-Ebola recovery period of
Sierra Leone and Liberia with lessons for future
health emergencies.
Tearfund & World Vision
Stephanie.Gill@tearfund.org
Desiree.Stewart@worldvision.org.uk
24th October 2017

2. Research Aims:
1. To establish the Ebola recovery policies of Sierra Leone and
Liberia, particularly for survivors and those affected by
Ebola.
2. To evaluate support received in practice by survivors and
others affected.
3. To record lessons learnt for recovery periods in future
health emergencies.
Methodology:
• Qualitative - Key Informant interviews, and Focus Group
Discussions.
• Quantitative - questionnaires involving a sample of survivors
and affected persons.
• 308 people from Sierra Leone and 77 people from Liberia
participated in the questionnaire.

3. Tearfund.org/aftertheoutbreak Tearfund.org/keepingthefaith

4. Key findings
Policy approaches
• Sierra Leone:
• The National Ebola Recovery Strategy (ERS) – 2015 (broader development focus)
• Comprehensive Programme for Ebola Survivors (CPES) - 2015
• Clinical Care for Survivors of EVD –2016
• Liberia:
• The Republic of Liberia EVD Survivors Care and Support National Policy - May 2016
• Liberia Ebola survivors Clinical Care Guidelines – 2016
Policy challenges:
- time lag
- coordination
- registration
- funding
- ambiguity about ‘free healthcare’
- health care challenges
> qualified health personnel
> drugs

5. Key findings cont.
Inclusion of survivors and affected persons
• The research emphasises how much affected persons have endured loss of livelihoods and
stigmatisation
• Unemployment increased from 1% to 20% for survivors and from 3% to 19% for other affected
persons and the effects are still being felt by both
• Affected persons are less likely to be targeted by initiatives than survivors themselves
• Proportion of respondents receiving support since the end of ebola:
Sierra Leone: Liberia:

6. Key findings cont.
Stigmatisation
• Respondents’ experience of stigmatisation
Sierra Leone:
Liberia:
Percentage who have
received counselling:
- Survivors: 35%
- Other affected
persons: 7%
Percentage who have
received counselling:
- Survivors: 81%
- Other affected
persons: 51%

7. Recommendations for future health
outbreaks
Produce recovery
policies in a timely
way
Inform communities
of their rights
Strong coordination
both within and
between affected
countries is crucial
Have clear and
effective registration
processes put in place
early on
Consider the needs of
affected people
alongside survivors
Ensure clarity on key
policy terms such as
‘free healthcare’
Do not underestimate
the length of time
that people will be
impacted by stigma

8. Why faith leaders?
• Trust
• Respect
• Reach
• Influence
What did they do?
• Safe burials
• Key messages
• Distributed items
• Addressed stigma
‘The participation of religious leaders was
a game changer.’
a
UN Staff member, Sierra Leone

9. Recommendation 7
“Engaging communities early is vital to
responding to a public health emergency. It
is unhelpful just to see cultural practices as a
barrier to tackling an outbreak, as this can
foster distrust between medical
professionals and communities.
Local and faith leaders can provide a
valuable avenue for spreading important
public health information and good
practices.”