Project summary

Imagine you are health worker in a clinic in remote village of Liberia (West Africa) and a patient arrives with symptoms of serious infection (i.e Ebola). You arrange for a sample to reach to central laboratory (in capital city - Monrovia). A courier carries it over long distance and difficult roads. But the journey is complete only when the test results are received at clinic. Who ensures if pick up is delayed, samples transported properly and results arrived or not?

STEP Liberia will explore these everyday challenges and test simple ways to address them. We need 25000 USD for a 3 months pilot involving total 4 health centers (clinics) in 2 counties of Liberia. Main focus for this project will be the stakeholder "Riders for Health" as they are already mandated/contracted out by Ministry of Health Liberia to transport samples from clinics to central lab (National Public Health Reference Laboratory - NPHRL) at capital city Monrovia, Liberia. We will invite them to share their experiences in this regard. Our next key stakeholder will be NPHRL where these samples are received and tested and then results are sent to National Public Health Institute of Liberia (NPHIL) for response to any lab confirmed epidemic infection. We will also get feedback from surveillance teams, health managers and community leaders.

Together we will identify where delays happen. We will then test practical improvements i.e designated points of contact, pickup and delivery updates, sample transportation protocols, turn around time for test results and response time taken by NPHIL/county health teams if there is some confirmed lab case. We will document what improves, what remains difficult and what support is needed to ensure timely and safe transport of samples from far flung areas to NPHRL and required public health response to lab tests results.

Simply put, our aim is to help samples move swiftly & reliably and results reach to people who can act on them.

What are this project's goals? How will you achieve them?

We will work towards 3 goals;

1. Understand where delays happen: we will review referral records of samples and speak with Riders for Health, health clinic staff, health managers, lab staff and community leaders. we will examine pick up delays, sample transport problems, turn around time for tests and communication of results.

2. Improve coordination and safe transport: Together with stakeholders, we will test simple changes i.e designated contact persons, pick up and delivery updates, and use of technology to track and transport samples from clinics to NPHRL. we will also address misunderstanding about testing and referral identified through community feedback.

3. Improve result feedback and follow up: we will track where results reach clinics, NPHIL and county teams promptly and properly. we will also examine how results are communicated to relevant teams/clinics for action.

How will this funding be used?

1. Local coordination and staff support - 6000 USD

2. Field travel and logistics: 5500 USD

3. project operations, analysis and reporting: 7500 USD

4. community engagement: 2500 USD

5. Dissemination and practical improvements: 3500 USD

Who is on your team? What's your track record on similar projects?

Our team is comprised of myself (Saeed Ahmad), Roland Beyan (local public health researcher, Phillip Bemah (NPHIL), Manager NPHRL and Manager (Riders for Health). As public health specialist, I have previously worked with NPHIL and conducted first of its kind nation wide disease surveillance system evaluation at national and subnational level. This is directly related experience regarding how health facilities, laboratories and surveillance teams work together to detect and respond to public health threats.

I have also recently completed successfully, with Manifund grant, Biosafety Laboratory Assessment Matrix (BLAM) in Liberia. This work focused on identifying NPHRL safety gaps in Liberia and priorities for improvement to achieve global health security through enhanced biosafety and biosecurity in place.

Moreover, I have existing working relationship and coordination with NPHIL, NPHRL and MoH in Liberia as well as with other partners working in public health ecosystem in the country. It will help me to coordinate better to achieve goals of this project.

What are the most likely causes and outcomes if this project fails?

Main risks I can anticipate are; delayed stakeholder participation, incomplete records, and logistical failures due to resource constraints or security situation in Liberia. It could limit us to identify delays, test improvements and measure results.

If this project fails, Liberia will be one step behind in enhancing global health security.

How much money have you raised in the last 12 months, and from where?

I received 10000 USD from Manifund and 14500 USD from SHIFT grants on biosafety and biosecurity projects led by me.