A Policy Analysis of the Primary Health Care Approach in Liberia

Abstract

Primary health care (PHC), a holistic approach to health, was proposed at Alma-Ata in 1978 and has been the guiding principle for the health system rebuilding of Liberia, a post-conflict, low-income country. However, since its adoption, health care delivery and outcomes remain less than optimal. A comprehensive literature review of all current health policy documents in Liberia, with a focus on the PHC approach, was identified and analyzed using the Walt and Gilson policy framework. Three major policy-related gaps were identified. 1. The lack of explicit inclusion of the community as an actor in the formulation of several of the policy documents. 2. The lack of timely revision of some policy documents. 3. The lack of an explicit PHC strategic approach in the implementation plans of multiple policy documents. The poor health outcomes in Liberia, therefore, are indicative of problems with PHC that go beyond implementation to the policy level.