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Abstract：
This article is part of the Research Topic \'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict\' Liberia is one of the three countries worst hit by the 2014-2016 West Africa Ebola Virus disease (EVD) outbreak, during which it recorded over 10,000 cases, including health workers. Estimates suggest that the non-EVD morbidity and mortality resulting from the collapse of the health system exceeded the direct impact of EVD. Lessons from the outbreak were clear, not only for Liberia but also for the regional and global communities: that building health system resilience through an integrated approach is an investment in population health and wellbeing, as well as economic security and national development. It is therefore no surprise that Liberia made recovery and resilience a national priority from the time the outbreak waned in 2015. The recovery agenda provided the platform for stakeholders to work toward the restoration of the pre-outbreak baseline of health system functions while aiming to build a higher level of resilience, informed by lessons from the Ebola crises. Based on the co-authors\' experiences of on-the-ground country-support work, this study sought to provide an overview of the Liberia Health Service Resilience project (2018-2023) funded by KOICA, and propose a set of recommendations for national authorities and donors, derived from the authors\' perceptions of best practices and key challenges associated with the project. We used both quantitative and qualitative approaches to generate the data represented in this study by reviewing published and unpublished technical and operational documents, and datasets derived through situational and needs assessments and routine monitoring and evaluation activities. This project has contributed to the implementation of the Liberia Investment Plan for Building a Resilient Health System and the successful response to the COVID-19 outbreak in Liberia. Although limited in scope, the Health Service Resilience project has demonstrated that health system resilience could be operationalized by applying a catchment and integrated approach and encouraging multi-sectoral collaboration, partnership, local ownership, and promoting the Primary Health Care approach. Principles applied in this pilot could guide the operationalization of health system resilience efforts in other resource-limited settings similar to Liberia and beyond.
摘要：
本文是研究主题“COVID-19和旷日持久的冲突背景下的卫生系统恢复”的一部分，利比里亚是2014-2016年西非埃博拉病毒病（EVD）爆发最严重的三个国家之一，在此期间，它记录了超过10,000个案例，包括卫生工作者。估计表明，卫生系统崩溃导致的非EVD发病率和死亡率超过了EVD的直接影响。疫情的教训是明确的,不仅对利比里亚，而且对区域和全球社区：通过综合方法建立卫生系统的复原力是对人口健康和福祉的投资，以及经济安全和国家发展。因此，从2015年疫情减弱之时起，利比里亚将恢复和复原力作为国家优先事项也就不足为奇了。恢复议程为利益攸关方提供了平台，以努力恢复爆发前卫生系统功能的基线，同时旨在建立更高水平的复原力。借鉴了埃博拉危机的教训。根据共同作者的实地国家支持工作经验，这项研究旨在提供由KOICA资助的利比里亚卫生服务弹性项目(2018-2023年)的概述，并为国家当局和捐助者提出一系列建议，源自作者对最佳实践和与项目相关的关键挑战的看法。我们使用了定量和定性的方法，通过审查已发表和未发表的技术和操作文件来生成本研究中代表的数据，和通过情况和需求评估以及常规监测和评估活动得出的数据集。该项目为实施利比里亚建设弹性卫生系统投资计划和成功应对利比里亚COVID-19疫情做出了贡献。虽然范围有限，卫生服务复原力项目表明，卫生系统复原力可以通过采用集水和综合方法并鼓励多部门合作来运作，伙伴关系,地方所有权,并推广初级卫生保健方法。该试点中采用的原则可以指导在类似利比里亚及其他地区的其他资源有限的环境中开展卫生系统复原力工作。
