Type of services provided

• Selection, mobilisation and supervision of international and national long-term experts, international short-term experts and personnel;
• Technical assistance and advice to the Ministry of Health (through membership in the AMR Steering Committee) and its sub-national structures at county level;
• Implementation of activities in close collaboration with key stakeholders and partner institutions (e.g. trainings, coaching and mentoring at facilities, production of guidelines and the development of systems, including procurement of laboratory reagents and equipment);
• Using the direct experience of implementation in the southeast to provide opportunities for piloting activities, ensuring the link between policy and operations and offering opportunities for scaling up across the country;
• Contributing data from the activities that it is supporting to start to build a national profile of AMR in line with international norms.
• Operational research (e.g. monitoring and evaluation (M&E) to enhance evidence-based strategic and operational decision-making;
• Project administration, monitoring and supervision in line with the GIZ instruments;
• Establishment and maintenance of a project office;
• Coordination with GIZ;
• Technical backstopping of the project/ quality assurance of deliverables;
• Contribution to GIZ’s Knowledge management (Collating project experience and best practice examples);
• Regular reporting to the client and partners.

Objective: To support a better evidence base on the anti-microbial resistance (AMR) situation in the south east, to contribute to optimising the use of antibiotics as well as building the national capacity to start with AMR surveillance.

Specific objectives:

• The development of national policy, technical guidelines, national reporting at the level of the National Public Health Institute of Liberia (NPHIL) and MoH, working with national stakeholders and other development partners.
• The development of a pilot sentinel surveillance AMR system in the south east to begin to gather data to inform and support guideline development, develop AMR profiles at key sites and estimating the extent of the resistance burden.
• The development of pilot antimicrobial stewardship programmes (AMS) at selected clinical sites as a systematic effort to educate and persuade prescribers of antimicrobials to follow evidence-based prescribing, in order to prevent antibiotic overuse, and thus antimicrobial resistance

Context: The interventions implemented by Health Focus in collaboration with the Universitätsklinikum Münster are part of the GIZ project “Post-Ebola Health System Strengthening and Epidemic Prevention” (PEGSS) that aims at strengthening Liberia’s health system to deliver quality health services for all Liberians.

Activities contribute to the development of policy at the national level and the implementation of project level activities at the clinical sites in the southeast to develop the surveillance system based on JJ Dossen hospital microbiology laboratory and the stewardship programme in two county hospitals. The focus of this networked approach is south east Liberia, with samples being collected from the county hospitals in Grand Kru, Maryland and River Gee being transported for testing to the new microbiology laboratory at JJ Dossen Hospital.

Key activities are:

• Sentinel Site engagement
• System building - selection of pathogens and tests, development of a stakeholder forum, development of reporting tools for all levels of the system that are aligned with the overall national reporting architecture
• Building laboratory capacity - identification of pathogens and drug sensitivity testing
• Creating a sample transfer network
• Engagement with County Health Team and Hospital staff
• Education and training - clinical (refresher training on diagnosis and treatment of common infections, disease specific training etc.) and systems-based (data collection tools, analysis of data etc.)
• Publicity and recording results.