Liberia - National Policy and Strategic Plan On Health Promotion, 2016 - 2021

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Table of Contents
ACRONYMS 4
GLOSSARY 5
FOREWORD 7
ACKNOWLEDGEMENT 9
EXECUTIVE SUMMARY 11
1. INTRODUCTION 13
2. SITUATION ANALYSIS 15
3. THE POLICY 19
4. KEY POLICY THEMATIC AREAS 20
5. INSTITUTIONAL ARRANGEMENT FOR IMPLEMENTATION 25
6. HUMAN RESOURCE FOR HEALTH PROMOTION 29
7. THE STRATEGIC PLAN 30
ANNEX 1: NHPD Organogram 32
ANNEX 2: TERMS OF REFERENCE FOR HEALTH PROMOTION
TECHNICAL WORKING GROUP AND SUB COMMITTEES 33
ANNEX 3: NATIONAL STRATEGIC PLAN MATRIX – 2016- 2021 34
REFERENCES 42
National Policy and Strategic Plan on Health Promotion

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ACRONYMS
AIDS Acquired Immuno-Deficiency Syndrome

BCC Behaviour Change Communication
BPHS Basic Package of Health Services
CBO Community Based Organization
CHAs Community Health Assistants
CHC Community Health Committee
CHDC Community Health Development Committee
CHOs County Health Officers
CHVs Community Health Volunteers
CSOs Civil Society Organizations
eDEWs Electronic Diseases Surveillance System
EVD Ebola Virus Disease
GDP Gross Domestic Product
HC3 Health Communication Capacity Collaborative
HIA Health Impact Assessment
HiAP Health in All Policies
HP Health Promoter
HPO Health Promotion Officer
HIV Human Immuno-deficiency Virus
HPSI Health Promoting Schools Initiative
IDSR Integrated Disease Surveillance and Response
IMR Infant Mortality Rate
INGOs International Non-Governmental Organizations
MGDs Millennium Development Goals
MOH Ministry of Health
NHPD National Health Promotion Division
NPSPHP National Policy and Strategic Plan on Health Promotion
NCDs Non-Communicable Diseases
NGO Non-Governmental Organisation
PACS Partnership for Advancing Community-based Services
PHC Primary Health Care
PSI Populations Services International
SBCC Social and Behaviour Change Communication
SDGs Sustainable Development Goals
WHO World Health Organization

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GLOSSARY
Capacity Capacity building and strengthening is the process of equipping

Building: individuals and communities with knowledge, skills, competen-
cies and abilities that enable them perform effectively.
Community Community participation (increasingly referred to as Community
Participation: Engagement) is a process through which people are enabled
to become actively involved in defining issues of concern to
them, in making decisions about factors affecting their lives, in
formulating and implementing policies, in planning, developing,
and delivering services and in taking action to achieve change.
Determinants of The range of personal, social, physical economic and
Health: environmental factors that determine the health status of
individuals or groups of people.
Evidence-based The use of information from formal research and systematic
Health investigations that contributes to identifying causes of health
Promotion: needs and provides evidence for the most effective health
promotion actions to address causes in the given context and
populations.
Health Outputs and Health outputs are the actual goods or services produced by
Outcomes: heath programmes or organisations (e.g., support group for
people affected by chronic diseases). Health outcomes measure
the impact or consequence of the output in the longer term (e.g.,
longer and healthier lives).
Health Promotion A health promotion intervention is an effort or activity aimed at
Intervention: enabling people to take control of their health and develop skills
to practice healthy behaviours like physical activity to prevent
unhealthy behaviours (e.g., smoking, illicit drug use or excessive
alcohol use).
Primary Health The Alma-Ata Declaration of 1978 identified primary health
Care Approach: care as the key to the attainment of the goal of “Health for All”.
The Primary Health Care approach focuses on health equity,
including all areas that play a role in health, such as access to
health services, environment and healthy lifestyle.
Social and SBCC for health is a research-based, consultative process that
Behaviour Change uses communication to promote and facilitate behavior change
Communication: and support the requisite social change for the purpose of
improving health outcomes.
Risk Risk Communication is the process for actively engaging all
Communication: affected stakeholders in identification and characterization of the
risk before, during and after disease outbreaks or health crisis.
mHealth: mHealth (also written as m-health) is an abbreviation for mobile
health, a term used for the practice of medicine and public
health supported by mobile devices.

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Information This is the practice of communicating promotional health

Education information, such as in public health campaigns, health
Communication: education, and between doctor and patient. The purpose of
disseminating health information is to influence personal health
choices by improving health literacy.
Behaviour Change BCC is the strategic use of communication to promote positive
Communication health outcomes, based on proven theories and models
(BCC): of behaviour change. BCC employs a systematic process
beginning with formative research and behaviour analysis,
followed by communication planning, implementation, and
monitoring and evaluation. Audiences are carefully segmented,
messages and materials are pre-tested, and both mass media
and interpersonal channels are used to achieve defined
behavioural objectives.
Advocacy: Advocacy is an activity by an individual or group which aims
to influence decisions within political, economic, and social
systems and institutions. It can include many activities that a
person or organization undertakes including media campaigns,
public speaking, commissioning and publishing research.
Social Social Mobilization is a broad scale movement to engage
Mobilization: people’s participation in achieving a specific development goal
through self- reliant efforts, taking into account the felt needs
of the people. Social Mobilization embraces the principle of
community involvement, and seeks to empower individuals and
groups for action.
Health Health promotions the process of enabling people to increase
promotion: control over their health and its determinants, and thereby
improve their health. It is a core function of public health and
contributes to the work of tackling communicable and non-
communicable disease and other threats to health.
Health Education: Health education is a profession of educating people about
health. Areas within this profession encompass environmental
health, physical health, social health, emotional health,
intellectual health, and spiritual health. It can be defined as the
principle by which individuals and groups of people learn to
behave in a manner conducive to the promotion, maintenance,
or restoration of health.
eDEWs: eDEWS is the Electronic Disease Early Warning System
(eDEWS) is an initiative that promotes the use of data and
information system standards to advance the development of
efficient, integrated, and interoperable surveillance systems at
federal, provincial and district levels.
eHealth: eHealth is the use of information and communication
technologies (ICT) for health. Examples include treating
patients, conducting research, educating the health workforce,
tracking diseases and monitoring public health

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FOREWORD
The Ebola Virus (EVD) outbreak in 2014 has grossly affected the social and economic status
of the people of Liberia. Our people have been affected by this epidemic, either directly
through illness (over 9000 cases) or deaths (4,408, including 184 health workers) of family
or friends or indirectly through the inability to access health services and the social economic
losses resulting from a slowdown of our economy. The country is also experiencing a
double burden of communicable, non-communicable and neglected tropical diseases and
conditions mainly due to social determinants of health.
In collaboration with our partners, we developed the Post Ebola Investment Plan aimed at
building a resilient health system which endeavours to restore the gains lost due to EVD crisis
and provides health security for the people of Liberia. The plan prioritized three investment
areas: build a fit-for-purpose productive and motivated health workforce that equitably and
optimally delivers quality services, reengineer the health infrastructure to conform to the
population’s needs for health services, and strengthen epidemic preparedness, surveillance
and response, including the expansion of the established surveillance and early warning
and response system to ensure it is comprehensive enough to detect and respond to future
health threats. These objectives will be achieved by forging strong partnership with our
people to increase trust in the health system, improving demand for health services, reducing
risks due to epidemics and other health threats; accelerating progress towards universal
health coverage and improving access to safe and quality health services. Health promotion
evidently is a central pillar of health services that creates a mutually beneficial interface
between communities and services by facilitating comprehensive integrated responses to
the broad determinants of health.
The National Health Promotion Policy of 2011 lacked a national plan and strategic
intervention approaches to appropriately respond to EVD and other large scale public health
emergencies. Within the context of on-going reforms being carried out in the health and

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other sectors, the policy review is a first step in an effort to refocus and intensify health
promotion activities in the country.
This 2016-2021 National Policy and Strategic Plan on Health Promotion (NPSPHP)
developed through a broad participation of key stakeholders builds on the broad aims and
orientations of the National Health and Social Welfare Policy and Plan 2011-2021 and the
Investment plan for building a resilient health system in Liberia 2015-2021. It is also aligned
to the Health Promotion Strategy for the African Region 2013 of which the Government
of Liberia is a signatory and has demonstrated commitment to the promotion of health.
The NPSPHP provides the necessary conditions and support to enable the promotion and
protection of health throughout Liberia.
The policy Participation and cooperation among all relevant partners and stakeholders is
envisaged so that the NPSPHP objectives are fully realized.
Bernice T. Dahn, MD, MPH

Minister of Health, Republic of Liberia.

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ACKNOWLEDGEMENT
The National Policy and Strategic Plan on Health Promotion (NPSPHP) review and
finalization would not have been possible without the contributions of MOH and various
health partners. The National Health Promotion Division (NHPD) of the MOH is very
grateful to health partners, organizations and individuals in the preparation and finalization
of the document. The MOH through the NHPD appreciates the involvement and the
overall attainment and goals of health partners by contributing to the accomplishment
of the NPSPHP. We acknowledge the valuable inputs and guidance of these individuals
for their immense contributions: Dr. Bernice T. Dahn, Minister of Health; Mrs. Yah Zolia,
Deputy Minister of Health-Planning, Research and Development; Mr. Tolbert Nyenswah,
Deputy Minister of Health- Disease Surveillance and Epidemic Control; and Dr. Sampson
Arzoaquoi, Assistant Minister for Preventive Services.
Recognition also goes to WHO-AFRO and WHO Liberia in providing technical and
financial support to facilitate the development process, paying attention to the details and
commitment to excellence which enhanced the content and quality of the National Policy
and Strategic Plan on Health Promotion. Similar gratitude in appreciation is extended to
Partnership for Advancing Community- based Services (PACS), Health Communication,
Capacity, and Collaborative (HC-3)/Johns Hopkins Center for Communication Programs
(CCP), United Nations Children’s Fund (UNICEF), Centers for Disease Control and
Prevention (CDC), Mercy Corps, United Nations Population Fund (UNFPA), United States
Agency for International Development (USAID), Inter-Faith-Religious Council and Liberia
Crusaders for Peace (LCP). Special gratitude goes to the late Siadeyo Torgbenu (RIP)
from PACS who devoted herself as Technical Assistant to the Health Promotion Division
for the development of this document. Special recognition goes to Rev. John B. Sumo,
Health Promotion Director, and the entire staff of the National Health Promotion Division
for their valuable services. We are grateful to Policy and Planning Unit (PPU), Community

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Health Services Division (CHSD), Family Health Division (FHD), Expanded Program on
Immunization (EPI), County Health Officers (CHOs), National AIDS Commission (NAC),
Ministry of Education (MOE), Environmental Protection Agency (EPA), Ministry of Youth
and Sports (MYS), Ministry of Planning, Finance and Development, and Ministry of
Information, Cultural Affairs and Tourism (MICAT) for their valuable contributions.
We anticipate the fullest cooperation and continued support from our health partners,
County Health Teams, and stakeholders including ministries and agencies for the
implementation of the document. It is our ardent hope that the NPSPHP will significantly
improve the functions of the NHPD and a healthier Liberia.
Dr. Francis Kateh, MD, MHA, MPS/HSL, FLCP

Deputy Minister for Health Services & Chief Medical Officer R.L

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EXECUTIVE SUMMARY
Health promotion seeks to enable individuals, families and communities to take control of
their health and thereby improve and maintain health outcomes. The focus goes beyond
the traditional primary and secondary preventive programs. The Government of Liberia
is a signatory to the Health Promotion Strategy for the African Region 2013 and has
demonstrated commitment to the promotion of health. Significant gains in improving the
health status of its people, specifically maternal and child health (LDHS, 2013) have been
registered since the end of civil war. Unfortunately, these gains were reversed by the
outbreak of the EVD of 2014 and 2015. The use of multiple health promotion strategies
largely contributed to the break in transmission of the EVD outbreak.
The country is still threatened by communicable, non-communicable diseases (NCD),

Neglected Tropical Diseases (NTDs) and other emerging and re-emerging diseases.
Another major setback is the limited number of skilled and non-skilled health professionals
engaged in health service delivery, specifically health promotion. Furthermore, there
has been significant reliance on information dissemination to create awareness instead
of strategies, sociocultural and behavioral change interventions. Such challenges are
compounded by inadequate resources for health promotion activities across the spectrum
of health interventions.
This National Policy and Strategic Plan on Health Promotion (NPSPHP) 2016 has
therefore been revised to guide effective health promotion implementation. The NPHPSP
is aligned with existing key strategic documents produced by the government that clearly
articulates its position in building a resilient health system. The NPHPSP recognises
health as a fundamental human right and sound social investment. It has seven
thematic areas namely: 1.Strengthening the leadership/stewardship for coordination and
management of health promotion; 2. Strengthening Human Resources Capacity for health
promotion; 3. Creating supportive environments conducive to health; 4. Strengthening
community actions for health; 5. Fortifying research and evidence-based health promotion
interventions; 6. Establishing risk communication strategies for epidemics and priority
public health conditions and 7. Instituting health promotion financing.
The strategic plan highlights key strategic actions for implementing the NPHPSP
and addressing current public health conditions as well as future emergencies. The
Government/MOH shall identify and secure funding from both local and international
partners for priority health promotion programs. The NHPD/MOH will collaborate with
health partners implementing health promotion interventions to ensure alignment with the
health promotion strategic plan.
The policy emphasises the need for multi-sectorial and multi-stakeholder collaboration in
promotion of health in Liberia. The NHPD/MOH is the coordination body and roles and
responsibilities of other sectors are well defined.
The strategic plan will be operationalized and monitored through the annual operational
plans. Regular supportive supervision, monitoring and evaluation of health promotion

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activities at different levels will be provided throughout the implementation phase of the
policy. A mid-term review of the strategic plan will be conducted in 2018 to assess progress
towards achieving the set goals and objectives. Data generated from monitoring and
evaluation efforts will provide evidence for tracking progress towards achievement of the
policy objectives. In 2020, a final evaluation of the strategic plan will be conducted, and a
new one developed within the context of the country plan strategic direction.

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1. INTRODUCTION
1.1 Historical Background
Health is regarded by the World Health Organisation (WHO) as a fundamental

human right and health promotion as a comprehensive social and political process
of enabling people to increase control over and improve their health and well-being
(WHO, 1986). The foundations for health promotion are premised in the Alma Ata
Declaration (1978), Ottawa Charter for Health Promotion (1986) and subsequent
WHO charters (WHO, 1986). Health Promotion recognizes that, the bulk of the
global burden of disease and the major causes of health inequities arise from
the conditions in which people are born, grow, live, work and age. These social
determinants of health are therefore significant and must be addressed to promote
good health through the life course, taking into account health equity, human rights
and a focus on gender equality. WHO has convened several conferences at both
the regional and international levels of which member states, including Liberia,
endorsed declarations for the implementation of recommendations calling for
collective efforts to improve health of population (WHO 2009).
As a commitment, the government of Liberia through the Ministry of Health

expanded the scope and functions of the then unit. The unit was renamed HP
Division. Subsequently, on December 12, 2005 the division was renamed the
National Health Promotion Division (NHPD). In 2011, the National Policy on Health
Promotion was formulated and operationalized to further strengthen the mandate
of the NHPD for the implementation of health promotion strategies and actions in
the country.
1.2 The Rationale for Revising the National Policy on Health

Promotion (NPHP)
Globally, populations and economies are grappling with Communicable diseases

e.g. measles, haemorrhagic fever, hepatitis, Non-Communicable Diseases
(NCDs) e.g. Cardiovascular diseases, cancers, chronic respiratory diseases and
diabetes, mental health disorders, disabilities and Neglected Tropical Diseases
(NTDs) e.g. Onchocerciasis, Leprosy, Buruli ulcer, etc. (WHO, 2008). However,
the burden of disease, disability and premature deaths in developing countries
is disproportionately high; yet most of the causes are preventable through health
promotion interventions (WHO 2008).
The African Region continues to experience new and re-emerging threats to public
health. These threats, related to social, economic, environmental, demographic
and political factors, include viral haemorrhagic fevers, influenza pandemics, drug-
resistant pathogens, natural and man-made disasters as well as effects of climate
change on health (HP strategy 2013). The disease burden has also started to shift
rapidly towards lifestyle and environmental related NCDs.

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Liberia’s health services were decimated by a civil war that lasted more than
a decade. During the recovery phase, the country further suffered a major
Ebola Virus Disease (EVD) outbreak from March 2014 to May 2015 with three
resurgences thereafter that were quickly controlled (Investment Plan 2015/21).
In addition, many people including health workers died and this devastated the
entire economy, thereby increasing mistrust amongst citizens on accessing health
services (WHO 2015). Health promotion played a crucial role through advocacy,
public education, social mobilization, community engagement and stakeholder
coordination to fight the EVD outbreak (R. Gladston, 2015). The Government of
Liberia in an effort to restore the health system developed an Investment Plan
for Building a Resilient Health System (2015-2021) and health promotion is well
articulated. Based on the proven cost effectiveness of health promotion, the MOH
deemed it necessary to review and update the current National Health Promotion
Policy 2011. This is to realign and make it more responsive to address the social
determinants of the current and emerging disease burden as well as readiness for
any future outbreaks.
1.3 The Policy Development Process and Linkages with Existing

Policies and Strategies
In preparation for the development of the NPSPHP, a desk review on health

promotion status in Liberia was conducted to begin the process. Additionally, a series
of consultative meetings and working sessions were held with key stakeholders
including policy makers, program managers, County Health Teams (CHTs), District
Health Teams (DHTs), community, line ministries and development partners. This
policy builds on the 2011 National Health Promotion Policy, and supports the goals
set forth in the National Health and Social Welfare Policy and Plan (2011-2021) as
well as the Investment Plan for Building a Resilient Health System in Liberia (2015-
2021). The Policy is also developed within the context of other relevant strategic
documents, including the MOH Recovery Plan (2014-2015), the Community Health
Services Policy (2016-2021), the WHO Health Promotion Strategy for the African
Region (2013), and the Integrated Disease Surveillance and Response (IDSR)/
International Health Regulations (IHR) Strategic Plan (2016-2020).
The strategic health priorities addressed in this Policy and Strategic Plan include
reproductive, maternal, new born and child health; mental health; disabilities;
communicable diseases, with focus on the priority diseases and events outlined
by the IDSR in Liberia (2015); non-communicable diseases, and neglected tropical
diseases.

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2. SITUATION ANALYSIS
2.1 Country Profile
Located in West Africa, Liberia borders Sierra Leone to the west, Guinea to the
north, Côte d’Ivoire to the east, and the Atlantic Ocean to the south. It covers an
area of 111,369 square kilometers, with a population of 4.4 million (World Bank,
2014). The country is geographically divided into five regions and 15 counties.
The county population ranges from the least populated - Grand Kru County to
the highest populated - Montserrado County i.e. 57,913 to 1.1 million respectively
(Lib National Pop and Housing Census 2008). Liberia continues to rank low on
the Human Development Index at 177 out of 188 countries and is considered a
low-income country with an estimated 2013 GDP per capita of US $454 (UNDP
2015). Although the real GDP growth in 2014 had been projected at 5.8%, it is
estimated to have declined to 2.5% or less by the end of 2014 due to the EVD
crisis (Investment Plan for Building a Resilient Health System in Liberia, 2015).
2.2 Overview of the health situation
Continuing its recovery after 14 years of civil conflict, Liberia was making health
gains, with improvements in a number of indicators within the 2013 Liberia
Demographic and Health Survey (LDHS) as compared to those in 2005. The
country had made efforts to rebuild the health system, first through the introduction
of the Basic Package of Health Services (BPHS) and then the Essential Package
of Health Services (EPHS), both defining the types of services including health
promotion to be delivered at all levels. Subsequently, significant gains were
registered in improving the population’s health status as outlined in the table below
(LDHS, 2013)
Indicators LDHS 2007 LDHS 2013

Total fertility rate 15-49 5.2 4.7
Unmet need for family planning 35.7 31.1
Infant mortality rate 71 54
Under-five mortality rate 110 94
Facility Deliveries 36.9 55.8
Children fully Immunized 39.0 54.8
The maternal mortality ratio continues to be one of the highest in the world,
but gains had also been made in decreasing maternal deaths. The LDHS 2013
indicated Liberia’s maternal mortality ratio decreased from 1,100/100,000 in 2005
to 994/100,000 in 2012, and then increased to 1,072/100,000 in 2013.
As a result of the EVD outbreak in 2014 and 2015, many of these gains in the
years since the civil strife have been reversed (Investment plan). Consequently,

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utilization of maternal and child health services declined due to disruption of the
delivery of routine health services, health worker fears and community distrust.
Communicable, Non-Communicable Diseases (NCDs) and Neglected Tropical
diseases continue to impact negatively on the health of the population (Investment
plan).
Therefore, the government is focusing on building a more resilient health system

that is able to respond effectively to future threats and to provide quality routine
health services for all (Investment Plan 2015-2021). Currently, special attention is
to strengthen health promotion and surveillance of the priority diseases and other
public health events to reduce morbidity, disability and mortality.
The importance of health promotion was demonstrated through the Ebola

response in Liberia, from strengthening community engagement and advocacy
for formulation of supportive policies to developing and disseminating appropriate
and relevant messaging to promote positive behaviour change (Oxfam, 2015).
Health Promotion, as outlined in this Policy, is poised to continue a crucial role in
supporting the country’s efforts to restore health services and strengthen health
systems including emergency readiness and response.
2.3 Current Health Promotion Implementation Status
The NHPD continues to coordinate the implementation of health promotion in

collaboration with partners in Liberia to enable individuals, families and communities
to adopt healthy behaviours. The division is headed by a Director and supported by
an Assistant Director. There are also five technical officers and six support staff. At
the county level, there is no dedicated staff to lead health promotion interventions.
As a result, staff of the County Health Teams interested in health promotion were
given refresher training in health promotion and communication and were assigned
an additional role as Health Promotion Focal Persons (HPFPs) in all the counties.
In an effort to enhance temporary support to social mobilisation activities during
the EVD outbreak, UNICEF deployed County Mobilization Coordinators (CMCs)
and District Mobilization Coordinators (DMCs) to assist NHPD. The CMCs and
DMCs play a key role in undertaking social mobilization activities in their assigned
counties and districts. At the community level,
Community Health Volunteers (CHVs) are selected by the community and trained
by MOH, CHTs and Partners to serve as frontline workers in health promotion
activities. The HPFPs, CMCs, DMCs and partners play a very significant role
in providing supervision and monitoring of CHVs’ activities for effective health
promotion delivery. There is increasingly a good working collaboration between
HPFP and the Community Health Focal Persons with close interaction of their
roles and responsibilities at community level.
There are, however, challenges that are affecting health promotion implementation
across the country. Nevertheless, there are opportunities that can be explored to
improve health promotion implementation in Liberia.

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2.4. Challenges and Opportunities for Health Promotion
2.4.1 Challenges
The key challenges to health promotion in Liberia have been categorized as

follows:
2.4.1.1 Institutional - Health promotion has not been fully integrated into all the relevant
divisions and programs that are providing services within the MOH, other
government institutions and the private sector. This is due to limited knowledge
and appreciation of health promotion among key stakeholders both within MOH
and in other sectors in order to give NHPD full support.
2.4.1.2 Capacity - Generally, there is a paucity of qualified health promotion professionals

in the country. This has affected the capacity to plan, implement, monitor and
evaluate health promotion interventions at all levels. Specifically, capacity gaps
exist in advocacy, risk communication, knowledge management, formative
research and data analysis.
County and district health teams also experience the shortage of staff, particularly
full time staff that are dedicated to health promotion activities at both the county and
district levels. This makes it difficult to build sustainable capacity and manpower for
effective health promotion. At the community level, the cadre of community health
workers including Community Health Volunteers (CHVs) have been instrumental in
promoting health. However, they have inadequate competencies in communication
skills and being volunteers makes it difficult to build a sustainable structure.
2.4.1.3 Planning for health promotion activities – Planning for health promotion activities
is mostly based on budget considerations or priorities. The selected activities are
communicated by top leadership and not guided by local health priorities and
situational analysis. The focus mostly is development of health education materials
and distribution without proper planning and assessment. Messages designed
are sometimes not evidence-based or meeting regional specific communication
needs.
2.4.1.4 Funding - Government budgetary allocation for health promotion interventions is

inadequate at all levels to support logistics and operations. The support for some
of the health promotion interventions being carried out is from bilateral agencies,
INGOs and other partners and is tagged along projects which is not sustainable
after the projects end. Another major challenge is the ability to identify and access
funding for health promotion and related activities embedded within various
divisions and programs at the MOH.
2.4.1.5 Accessibility – There have been intensive community mobilization and advocacy
initiatives especially during and after the Ebola outbreak, particularly to encourage
people to access appropriate health care services and to adopt positive health
practices at home. Unfortunately, poor physical access to health care facilities

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especially in less endowed communities constrains timely and appropriate health

seeking behavior. Other issues affecting accessibility include poor attitude and
inadequate communication skills of health workers, drug stock outs, preference
for alternative medicine, and poverty. As a result, health promotion interventions
may increase motivation for behavior change, but limited access to products and
services remains a barrier.
2.4.2 Opportunities
Government of Liberia and development partners commitment to supporting

and prioritizing health promotion as one of the key programs within the national
health strategic plan
• Supportive structures existing to protect and promote health in public and

private sectors
• Strong partnerships existing within MOH and between other line
ministries, organizations and partners
• Strong linkages and cooperation existing between Ministry of Health, local
authorities, religious and traditional leaders
• Growing improvement in access to information communication tools
including e-DEWS, eHealth and mHealth in Liberia
This policy provides a framework which will help address the challenges, utilize
existing opportunities and build capacity to improve health promotion delivery in
Liberia.

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3. THE POLICY
3.1 Mission
To create an enabling environment to foster adoption and maintenance of healthy

behaviours/ practices among individuals, families and communities through
information, education, advocacy, mobilization and empowerment.
3.2 Vision
Individuals, families and communities are empowered to make informed decisions

and choices to improve their health and well-being.
3.3 Goal
To create a sustainable framework that will guide all stakeholders in the provision
of accurate, relevant and appropriate health information that will help individuals,
families and communities make informed decisions to improve their health and
wellbeing.
3.4 Objectives
1. To provide a legal framework to strengthen leadership for the

development and implementation of health promotion in Liberia
2. To establish a mechanism for planning, monitoring and evaluating health
promotion interventions on both processes and outcomes.
3. To empower individuals, families, communities and civil society ’ for their
active involvement and participation in health promotion interventions
4. To promote evidence-based research as a prerequisite for the
development of health promotion interventions
5. To promote multi-sectorial and multi-disciplinary approaches to health
promotion development and implementation
3.5 Guiding Principles
The National Policy on Health Promotion is guided by the following:
• Health as a fundamental human right and sound social investment.

• Equity in health to ensure access, availability and affordability of health
promotion services for all.
• Intra and inter-sectoral collaboration and coordination of various players
to advance health outcomes.

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• Empowerment of individuals, families and communities to fully participate

in promoting their health.
• Building healthy public policy.
• Mutual accountability and shared responsibility among national
governments, service providers, funding agencies and intended
beneficiaries in order to monitor implementation and progress, including
financial management and agreed commitments.
• Professional ethics and standards.
• Delivery of evidence-based, gender and culturally sensitive and people-
centred health promotion interventions.
4. KEY POLICY THEMATIC AREAS
In order to achieve the policy objectives, the thematic areas of focus are as follows:
1. Strengthening the Leadership for coordination and management of health

promotion
2. Strengthening Human Resources capacity for Health Promotion
3. Creating supportive environment conducive to health
4. Strengthening community actions for health
5. Fortifying research and evidence-based Health Promotion interventions
6. Establishing risk communication strategies for epidemics and priority
public health conditions
7. Instituting health promotion financing
4.1 Strengthening the Leadership for Coordination and

Management of health promotion
The National Health Promotion Division’s role is to provide leadership, oversight,

coordination, guidance, research, monitoring and evaluation of health promo-
tion interventions across levels i.e. national, county and district. It will collaborate
with the departments, Community Health Services Division structures and other
stakeholders i.e. line ministries and government departments, the private sector,
Civil Society Organizations (CSOs), CHVs and communities. The division will work
closely with the Ministry of Information Culture Affairs & Tourism (MICAT) and other
media outlets in order to reach a wide audience. An Advisory Committee compris-
ing of multi-sectoral stakeholders shall be established to provide guidance to the
NHPD.
The National Policy on Health Promotion will:
• Develop norms and standards and collaborate with relevant bodies to

regulate the practice of health promotion in Liberia.
• Support the establishment of a Professional body/National Health
Promotion Association that will provide a forum for advocacy, consultation

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and improved level of governance for Health Promotion practice.

• Develop, implement and oversee National Health Promotion Strategic
and Operational Plans in collaboration with other stakeholders and
programs.
• Review and strengthen health promotion management and
implementation structures to respond to new developments and policy
changes; including emergencies and other challenges that affect health
and health systems.
• Provide policy direction and technical guidance for effective
implementation of health promotion programs.
• Advocate for the establishment of a multi sectoral advisory committee to
provide technical guidance to the NHPD.
4.2 Strengthening Human Resources Capacity for Health Promotion
Effective implementation of the health promotion policy relies heavily on the avail-
ability of adequate skilled human resource at all levels. Training in health pro-
motion should be provided to people from health and non-health backgrounds
through pre-service, in-service, continuing education and post- graduate training.
Health promotion training programs should provide trainees with a wide range of
competencies including content and practical skills to address social, cultural and
behavioral aspects of health. Government of Liberia should support the establish-
ment of health promotion training in institutions of higher learning.
• Ensure leadership for human resources development for health

promotion.
• Continually forecast and deploy skilled health promotion human
resources in line with prevailing needs.
• Encourage and provide opportunities for Health Promotion practitioners
to improve their knowledge and skills through continuing education and
networking.
• Collaborate with training and regulatory institutions to establish pre-
service and in-service training in health promotion for Government and
Private Institutions in line with current national health promotion needs
and standards.
• Standardize the categorization, titles, terms of reference/job descriptions
and deployment of different providers of health promotion services.
• Advocate for adequate motivational packages such as but not limited
to career development, scholarships, transport and accommodation for
health promotion practitioners especially in the counties.
4.3 Creating supportive environment conducive to health
Creating a supportive environment consists of advocacy for supportive policies

and adapting or altering social, political, economic or physical surroundings in

22
ways that will help to maintain and enhance health and wellbeing. Usually this
requires behaviour change at individual, family, organisational and community
levels. Health promotion interventions should also take into account a settings
approach to address the crucial factors affecting health within the contexts in which
people live, work, play and thrive.
• Engage communities to harness traditional/cultural, religious norms,

values and practices and related resources for the collective good.
Communities will be further engaged and involved in decision-making,
planning, mobilizing resources and delivery of health promotion
interventions.
• Develop and maintain initiatives that promote safe and healthy
environments in different settings, personal hygiene practices, healthy
lifestyles, healthy eating options and personal safety to reduce risks.
• Advocate for Health Promoting Schools that empower learners and
educators to adopt healthy lifestyle practices including healthy eating
habits, prevention of substance abuse (including tobacco, alcohol and
drugs), increased physical activity, and effective life skills and safer sexual
practices.
• Advocate and lobby for Health in All Policies (HiAP) that focus on creating
environments that are conducive to health such as smoke free, disability
friendly, safe housing, clean water, sanitation and safe work places.
• Work with the private sector and labour/trade unions to promote healthy
lifestyle practices within the workplace. This may include promoting
occupational health and safety practices, physical activity, moking
cessation, providing HIV and maternal and child health programmes.
4.4 Strengthening Community Actions for Health
The National Policy on Health Promotion will promote concrete and effective com-
munity actions to enable individuals and communities to assume power over their
personal, socio-economic and environmental factors that affect their health. It will
aim to identify existing community resources that enhance self-help and social
support. It will further encourage development of flexible systems for strengthen-
ing public participation in health matters. Promotion of community participation
improves and enables communities to take responsibilities of their own health.
• Collaborate with Community Health Services Division to strengthen

community structures to ensure responsibility and ownership for health
promotion programs.
• Promote equity and gender balance and incorporate specific needs of key
populations, especially youth, vulnerable and marginalised communities
in the planning and implementation of health promotion interventions.
• Establish a participatory approach involving all stakeholders in planning,

23
implementation, monitoring and evaluation of health promotion

interventions at all levels.
• Develop and implement evidence-based Social and Behaviour Change
Communication (SBCC) programs using appropriate channels of
communication including community radio, folk media to increase health
literacy to promote health and well-being.
• Develop partnerships and strengthen collaboration between the health
sector, communities, private sector, other government departments, and
stakeholders that will influence the health and well-being of the people.
• Ensure that health providers (public and private) develop and embrace
an expanded mandate that is responsive to the needs of the particular
community in which they are working.
4.5 Fortifying Research and Evidence-based Health Promotion

Interventions.
The National Health Promotion Policy recognizes that health promotion programs
are multi-faceted and have both a direct and indirect impact on health outcomes.
Health promotion interventions shall be planned based on evidence to make the
desired impact (WHO, 1998). Operational research shall be central to informing
health promotion programs. Both qualitative and quantitative information should
be gathered and analysed in order to document the efficacy and effectiveness of
health promotion interventions.
• Promote the utilisation of formative research that involves the audience

in the design of messages, materials and the identification of the most
appropriate communication channels to influence social and behavioural
change outcomes.
• Monitor the implementation of health promotion interventions using
current planning systems (e.g. strategic plans, annual performance
plans and operational plans with specific health promotion indicators and
routine program evaluations).
• Document impact of health promotion interventions and scale up
evidence-based best practices.
4.6 Establishing risk communication strategies for emergencies

and priority Public Health conditions
The National Policy on Health Promotion recognised that Liberia is threatened

by emerging and re-emerging diseases of epidemic potential. These require
exchange of real-time information, advice and opinions between experts and
people facing threats to their health, economic or social well-being. This involves
use of varying health promotion approaches/strategies including social media,
interpersonal communications and community engagement to enable people at
risk to take informed decisions to protect themselves and their loved ones.

24
• Promote risk communication based on sound understanding of people’s

perceptions, concerns rumours and beliefs as well as their knowledge
and practices.
• Promote the use of both the traditional communication mediums
(television, radio, posters, pamphlets, billboards, and video) and new
communication mechanisms (mobile text messaging, internet and social
media) to enable effective communication of health information and
messages essential to effect behavioural and structural change.
• Strengthen community engagement and advocacy with key stakeholders
to promote ownership and sustainability of the community based
response or interventions.
4.7 Instituting Health Promotion Financing
Adequate financing is essential for sustainable health promotion interventions.

Currently, there is inadequate resource allocation for health promotion programs
to adequately address the challenges due to the growing burden of disease. MOH
shall ensure development of sustainable health promotion financing system for
sustainability of health promotion development and implementation in the country.
• Ensure that MOH increases budget allocation for health promotion

implementation across programs at national, county, district and
community levels.
• Advocate for a mechanism to pool resources from development partners,
private sectors and other funding agencies for implementation of priorities
as stipulated in the health promotion strategic plan.
• Advocate for innovative ways of additional funding for health promotion.
Specifically, sin taxation by government on products that is harmful to
health including alcohol, tobacco and soft drinks to be dedicated for
health promotion development and implementation.
• Promote self-funding for health promotion activities or interventions by
individuals or group of people to ensure that they take actions to improve
their health and well-being.

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5. INSTITUTIONAL ARRANGEMENT FOR

IMPLEMENTATION
This policy embraces the Health in All Policies (HiAP) and seeks to define different
roles and responsibilities of all stakeholders within government, across all sectors
and levels. They will collaborate to address the social determinants and underlying
causes of poor health for improved health outcomes.
5.1 National Level
At the national level, the NHPD shall:
• Be the leading coordinating body for all health promotion programs and
activities in the country. (Annex 1)
• Work closely with Community Health Services Division (CHSD) and
other partners to develop the capacity of the community health cadres,
Community Health Assistants (CHA)/Community Health Volunteers
(CHVs)and other community structures in health promotion strategy and
skills especially strategic communication
• Provide leadership on the implementation, monitoring and evaluation of
the National Policy on Health Promotion and Strategic Plan
• Develop and disseminate policies, strategies, operational guidelines
and standards for health promotion practice including advocacy, social
mobilisation, risk communication, message and material development
• Advocate for adoption of healthy public policies in non-health sectors
(both public and private)
• Provide supportive and technical leadership in health promotion and
related research and set priorities for the research agenda. This will
include establishing and maintaining a resource centre
• Establish and support multi-sectorial and multi-disciplinary collaboration
or partnerships amongst all relevant stakeholders for the purposes of
developing integrated and comprehensive health promotion programmes
(Annex 2)
• Serve as a clearing house for all developed health messages and
materials in the country
• Facilitate and support general and specialist training in health promotion
with higher educational institutions and other relevant organizations.
• Establish a joint monitoring and evaluation mechanism for health
promotion implementation at all levels to ensure standardization and
efficiency
5.2 County Level
At the county level, a Health Promotion Unit (HPU) shall be established, with a
County Health Promotion Coordinator for effective implementation of health

26
promotion interventions. The County Health Promotion Coordinator will oversee

and supervise the implementation and monitoring of the National Policy and
Strategic Plan on Health Promotion at county, district and community levels.
The NHPD shall collaborate with the County Community Health Services
Department, other departments and programs as well as both international and
local NGOs for improved delivery of health promotions activities.
5.3 District Level
The CHT will support the District Health Team (DHT) to ensure that a District
Health Promotion Officer is deployed in each District. The District Health Promotion
Officer (DHPO) under the supervision of the District Health Officer (DHO) and the
County Health Promotion Officer will be responsible for planning, implementing
and monitoring of health promotion programs in the district and community levels.
He/she will also support and collaborate with partners and other stakeholders in
the implementation of health promotion activities.
5.4 Community Level
At the community, health promotion activities will be coordinated in collaboration

with the community health services structure and within the framework outlined in
the Community Health Services Policy 2016-2021. The Health Promotion Officers
shall work with the CHFP, CH supervisors at facility level and CHAs/CHVs for
health promotion activities program specific for community level. Health Promotion
is part of the integrated package and so the HPFP will support the monitoring of
these activities. Other activities for communities situated more than five kilometres
from the nearest health facility the HPFP will work with the CHC/CHDC cadres
which include CHAs, Community Health Volunteers (CHVs), Trained Traditional
Midwives (TTMs) and Community Health Support Groups, Community Leaders,
Faith-based organizations, Women and Youth Groups among others. Through
these community structures community health promotion needs will be identified,
prioritized and action plans developed. The County HPFP and the District Health
Promotion Officer shall, in collaboration with the community health team, build the
capacity of the community structures to facilitate effective strategic communication
for improved health in line with the policy.
5.5 Roles and Responsibilities of Key Stakeholders
The importance of multi-stakeholder collaboration for effective health promotion

implementation cannot be overemphasized. As mentioned earlier, this policy
will promote the HiAP approach that will incorporate health considerations into
decision making and policies by both the public and private sectors. The following
are some of the roles and responsibilities of key stakeholders to promote health
and well-being of all people in Liberia.

27
Sector / Body /
Roles and Responsibilities
Stakeholder
MOH Will allocate adequate resources and recruit qualified
professionals to spearhead the implementation of the
National Policy and Strategic Plan on Health Promotion.
It will also mainstream health promotion across priority
health programs in various divisions/units.
Ministry of Finance and Timely disbursal of approved funding for Health
Development Planning promotion through the MOH.
Ministry of National Provide security for the population to protect their safety
Defence to enhance their health and well-being.
Ministry of Justice Ensure timely adjudication of cases that threaten lives
and property. Enforce health regulations to protect lives
and property and to promote public safety.
Ministry of Agriculture Ensure food security and collaborate with MOH to
prevent animal-human transmission of diseases.
Ministry of Internal Empower the local government and traditional leaders
Affairs to engage and promote community ownership of health
promotion programs.
Ministry of Education Empower teachers, students, parents, guardians
and other stakeholders with a set of principles and
actions to promote and maintain health. Collaborate
in strengthening and expanding the school health
programme.
Ministry of Lands, Mines Ensures development of patterns, designs and planning
and Energy/National decisions have a positive effect on accessibility,
Housing Authority promotion of physical activity and good health.
Collaborate on environment friendly land use and
housing to prevent diseases related to overcrowding,
poor sanitation, water reticulation and air quality.
Ministry of Post and Ensure that appropriate technological infrastructure and
Telecommunications/ applications are in place to support mHealth and eHealth
Liberia interventions
Telecommunications
Authority
Ministry of Information, Regulate, promote and provide timely information for the
Cultural Affairs and promotion and protection of public health
Tourism/ Press Union of
Liberia
Ministry of Labour Promote occupational health, employment and job
security.

28
Ministry of Transport Collaborate with MOH and other line ministries and
agencies on road safety and protection of environment
from traffic and transport related harm (e.g. accident
prevention, emissions and pollution).
Ministry of Commerce Regulate industry and protection of health from vested
and Industry interests through licencing, taxation, pricing, advertising
etc.
Ministry of Foreign Negotiate and facilitate cross-border, regional and
Affairs international collaboration and support for health
Training Institutions Train and institute certification of health promotion
professionals; and mainstream health promotion (core
module) into all health and allied programs
WHO, UN agencies and Provide technical support and partner coordination
other Development
Partners.
Civil Society Advocate for societal rights and hold government
Organizations (CSOs) accountable in ensuring the health and well-being of all.
including INGOs, NGOs Complement the work of government within stipulated
and CBOs parameters and standards
Communities Promote ownership, leadership, support and execution of
community based and community focused interventions,
partnerships with government and other stakeholders.

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6. HUMAN RESOURCE FOR HEALTH

PROMOTION
6.1 WHO DOES HEALTH PROMOTION
Health promotion has been effectively applied in addressing the social and broad
determinants of health and calls on the involvement of other players beyond
the health sector. These include environmental health officers, school teachers,
agricultural extension workers, community development officers, social workers,
political and civil leaders (including religious and traditional leaders) nutrition
educators, CSOs and the private sector. This indicates that, everyone involved in
Health Promotion may not have the professional training. In this regard, the policy
shall recognise such individuals and groups involved in Health Promotion activities.
However, the health promotion activities will be harmonized through professional
guidance by the NHPD and the advisory committee in order to promote the health
of the population.
6.2 CATEGORIES OF HEALTH PROMOTION PROFESSIONALS
The Policy recognizes the following categories:
1. Health Promotion Specialists (HPS)

These are individuals with a health related educational background and
have received specialized training in Health Promotion at Masters/PhD
level from a credible institution.
2. Health Promotion Officers (HPO)

These constitute individuals who have had minimum training in Social
Behavior Change Communication and a minimum of Bachelor’s Degree
in Health Promotion.
3. Health Promoters (HP)
These are individuals with a minimum of High school certificate with
basic training in Social Behavior Change Communication and Health
Promotion.
NB: The policy is cognizant of the fact the currently Liberia does not offer training
in health promotion. However plans are underway to establish suitable training
programs to address this need as well as updating existing curriculum with health
promotion module especially for mid-level professionals.

30
7. THE STRATEGIC PLAN
The strategic plan will identify strategic actions for health promotion implementation
in line with the policy above. The effective implementation of this strategic plan is
on the assumption that adequate human and financial resources will be available.
Annually, operational plans will be drawn from the National Strategic Plan Matrix
(Appendix 3).
7.1 Objectives
The objectives of the Strategic Plan are:
1. To strengthen leadership / stewardship roles of the NHPD at the national,

county and districts and community levels.
2. To build the capacity of adequate manpower for delivering of health
promotion at all levels.
3. To empower individuals, families and communities to adopt and practice
healthy behaviors.
4. To advocate for supportive environment for adapting or altering social,
political, economic or physical surroundings to maintain and enhance
health.
5. To establish sustainable mechanisms for gathering information on
effectiveness of health promotion to inform policy and programing.
6. To strengthen multi-sectoral and multi-disciplinary health promotion
interventions to address priority public health conditions and disease
outbreaks.
7. To mobilize adequate resources for implementation of agreed health
promotion activities at all levels.
7.2 Financing and Costing the Strategic Plan
The Government of Liberia through the MOH shall make available adequate
budgetary allocation and prompt disbursement of funds to the NHPD for the
implementation of the strategic plan. The Government/MOH shall identify and
secure funding from government allocations, local and international partners
and the private sector for priority health promotion programs. The NHPD/ MOH
will collaborate with health partners implementing health promotion in Liberia to
ensure they are aligned with the health promotion strategic plan. This will help to
avoid duplication of resources and effort for improved health outcomes at all levels.
The estimated budget for the implementation of the strategic plan is based on
estimates. The budget of the annual plans may be subject to the actual market
prices and prevailing economic conditions in the country, region and across the
world.

31
7.3 Monitoring and Evaluation
Monitoring and evaluation (M & E) is essential to provide evidence-based

information to guide the planning, coordination and implementation of the
NPSPHP. The Policy will be monitored through the Strategic Plan which will be
operationalized and evaluated through the annual operational plans. Regular
supportive supervision at different levels will be provided throughout the phase of
the policy implementation. A mid-term review of the strategic plan will be conducted
in 2018 to assess progress towards achieving the set goals and objectives. In
2020, the strategic plan will undergo a final review, and lessons learnt will inform
the updating of a revised policy. Data generated from M & E will provide evidence
for tracking progress towards achievement of the policy objectives. The services
of external evaluator within or outside the country will be employed.
Implementation of the M & E plan will be coordinated by MOH through the NHPD
in collaboration with the M & E and Research Units; County Health Teams and
stakeholders under the Health Promotion Technical Working Group (HPTWG)
and the advisory group. The joint monitoring team will ensure development of
standardized data collection tools to deliver a cost-effective, multidimensional
monitoring and evaluation system that supports continuous improvement of health
promotion in Liberia. Additionally, information technology and software such as
magpi, eDEWS will be harnessed to improve efficiency of M&E and promote
triangulation of data from different sources/systems to enable a comprehensive
evidence-based approach to M&E. Health Promotion indicators will be collected
through the HMIS to monitor progress against targets. Building capacity for M &
E will be a prerequisite for better data management and use to improve health
promotion implementation in Liberia.

32
ANNEX 1
NHPD Organogram DIRECTOR
15 Country Health
Technical Advisor Assistant Director
Promotion Co-ordinators
Material and District health

Health Education Advocay & Social Communication &
Messages Promotions Officer
Research Mobilization resource centre
Development
Health
Co-ordinator Co-ordinator Co-ordinator
Communication
Asst. Co-ordinator Asst. Co-ordinator Asst. Co-ordinator
Officer

Asst.
Health Promotion Health Promotion Health Promotion
Communication
Officer Officer Officer
Officer
33
ANNEX 2
TERMS OF REFERENCE FOR HEALTH PROMOTION TECHNICAL

WORKING GROUP AND SUB COMMITTEES
In order to ensure that all sectors such as NGOs, and other partners participate fully in
the development and implementation of health promotion, a Health Promotion Technical
Committee shall comprise of membership from multi-sectoral and multi-disciplinary
bodies. The composition will include but not limited to; National AIDS Commission,
Ministry of Commerce, Ministry of Labour, Ministry of Justice, National Legislature,
Ministry of Agriculture, Ministry Information, Culture and Tourism; Ministry of Education,
Environmental Protection Agency, Ministry of Gender, Children & Social Protection;
Institutions of learning, NGOs, CBOs and development partners including UN agencies
and Faith-based organizations. The Technical Working group will have two sub-committees
namely:
• Advocacy and community engagement

• Messages and Materials Development
The TORs of the Technical working group are:
• Facilitate the coordination of partners and Health promotion networks

• Facilitate sharing of information and experiences
• Advise NHPD/MoH on developments in health promotion policy and practice
• Periodically review and update communication strategies
• Through the MMD subcommittee provide technical support to messages and
materials development as well as serve as a clearing house for all health and
health related messages and materials.
• Undertake advocacy for health promotion and garner support from policy makers,
media, religious and opinion leaders
• Hold meetings on a regular basis chaired by the Director Health Promotion and
co-chaired by a nominated agency
The sub-committees will develop their TORs and meet on a regular basis and report to
the working group.

34
ANNEX 3: NATIONAL STRATTEGIC PLAN MATRIX – 2016 - 2021

Responsible Time -
Strategic Areas Required Actions Results/Outcome Indicators
Body Frame
Objective 1: To strengthen the leadership roles of the NHPD at the National, County and District levels
Strengthening Develop Annual National Annual national health pro- NHPD/MOH Annual operational plans Year 1-5
the leadership for Health Promotion opera- motion plans developed at developed
coordination and tional plans in collaboration all levels – national, county
Management with other stakeholders and district
Implement Annual Annual National Health Activities implemented Year
National Health Promotion Promotion Operational under the Annual National 1-5
Operational plans at all plans implemented Health Promotion
levels Operational plans
Conduct assessment National, county and district “ Assessment report Year 1,
to establish capacity health promotion capacity completed 3 & -5
needs for leadership for needs identified.
national health promotion
coordination and
management
Strengthen the capacity Capacity of health Annual training plan Year 1-5
of health promotion promotion management available
management and strengthened at all levels % of persons trained
implementation structures Training report indicating
based on capacity pre and post- test
assessment to provide assessment results

leadership, oversight, available
coordination, monitoring
and evaluation of health
promotion including
emergencies and other
challenges that affect
health.
Strengthening Develop norms and Regulatory framework for “ Health Promotion Year 1
the leadership for standards and collaborate health promotion practice Framework document
coordination and with relevant bodies to established available
Management regulate the practice of
health promotion in Liberia.
Spearhead the Health Promotion “ Registration certificate Year 1-2
establishment of a Association established available
professional association
that will provide a forum for
advocacy, consultation and
governance
Develop technical guidance Technical guidelines for “ National Health Promotion Year 1-2
for effective implementation effective implementation of Communication Strategy
of health promotion health promotion developed available National
services Emergency Risk
Communication Strategy
available County specific
guidelines/SOPs for
communication during
emergencies available
Synthesized health
promotion M & E
tools available
Objective 2: To build the capacity of adequate manpower for delivering of health promotion interventions at all levels
2. Strengthening Forecast and deploy skilled Skilled human resource for “ # of skilled human resource Year 1-5

Human Resource health promotion human health promotion deployed for health promotion
Capacity for resources in line with deployed
Health Promotion prevailing needs
Outcome
35
36
Responsible Time -
Body Frame
2. Strengthening Identify and provide Training opportunity and “ # of health promotion Year 1-5
Human Resource capacity strengthening fellowship/scholarships practitioners obtaining
Capacity for opportunities for health scheme for health Diploma, Bachelors and
Health Promotion promotion practitioners to promotion at Diploma, degrees within and outside
Outcome improve their knowledge Bachelors level, or Masters Liberia
and skill. level established
Collaborate with training Health promotion training # of institutions of higher Year
and regulatory institutions program in selected learning offering pre 1- 5
to establish pre-service and institution(s) of higher service and in service
in-service training in health learning in Liberia training programs in health
promotion for Government established promotion in Liberia
and Private Institutions in
line with current national
health promotion needs and
standards.
Develop framework for Framework for NHPD/ Organogram and job Year 1
standardization and, standardization and MOH/ Civil descriptions for NHPD
categorization, titles, categorization of health Services available
terms of reference/ promotion professionals in Framework for
job descriptions and Liberia developed categorization of Health
deployment of health Promotion Professionals in
promotion services Liberia available.
Objective 3: To empower individuals, families and communities to adopt and practice healthy behaviors.

3. Strengthening Strengthen community Community ownership CHSD/ # of community structures at Year 1-5
community structures to ensure of health promotion NHPD/ MOH all levels strengthened
Actions for health responsibility and interventions at all levels
ownership for health strengthened
promotion programs
3. Strengthening Promote equity and Equal participation of both CHSD/ % of males and females
community gender balance and males and females in NHPD/ MOH participation in planning,
Actions for health incorporate specific needs planning, implementation, implementation, monitoring
of key populations and monitoring and evaluation and evaluation of health
marginalized communities of health promotion promotion interventions at
in the planning and interventions at all levels all levels
implementation of health increased
promotion interventions
Establish a participatory Involvement of identifiable CHSD/ # and categories of key
approach involving all groups and key NHPD/MOH/ stakeholders involved in the
stakeholders in planning, stakeholders in planning, Partners planning, implementation,
implementation, monitoring implementation, monitoring monitoring and evaluation
and evaluation of health and evaluation of health of health promotion
promotion interventions at promotion interventions at interventions at all levels.
all levels. all levels increased.
Develop and implement Evidence-based SBCC CHSD/ % of individuals, households
evidence- based social programs to influence NHPD/MOH/ and communities who have
and behaviour change positive behaviors by Partners received health information
communication (SBCC) individuals, families and adopting to healthy
programs using appropriate and communities to behaviours
channels of communication take ownership of their
including community radio, own health and well-
folk media to increase being developed and
health literacy to promote implemented.
health and well- being
Develop partnerships and Partnership between the MOH/ NHPD % of multi-sectoral

strengthen collaboration health sector, communities, and multi-disciplinary
between the health sector, private sector, other partnerships and
communities, private government departments collaboration to promote
sector, other government and CSOs for health health and well-being of
departments, and CSOs promotion developed and/ all people developed and
that will influence the strengthened strengthened
health and well-being of the
people
37
38
Responsible Time -
Body Frame
3. Strengthening Develop an expanded Expanded mandate for MOH/ NHPD % of health providers
community mandate for health health providers (public (public and private) with
Actions for health providers (public and and private) relevant to the skills provide services
private) that is responsive needs of their operational responsive to the needs
to the needs of the areas developed of their operational areas
particular community in developed and/ expanded
which they are working;
Objective 4: To advocate for supportive environment for adapting or altering social, political, economic or physical surroundings to
maintain and enhance health.
4. Creating Engage communities to Communities empowered to # of communities
supportive harness traditional/cultural, change harmful traditional/ empowered and have
environments religious norms, values cultural and religious changed harmful traditional/
conducive to and practices and related practices to reduce the cultural and religious
health resources for the promotion health risks. practices to promote health
of health and well-being. Communities effectively and well-being
utilizing local resources to # of communities utilizing
enhance health local resources to enhance
health
Identify and maintain Health promotion NHPD/ # of health promotion
initiatives that promote safe interventions that DEOH/MOH interventions that
and healthy environments promote safe and healthy promote safe and healthy
in different settings, environments implemented environments implemented
personal hygiene practices, and sustained at all levels and sustained
healthy eating options and

personal safety to reduce
risks;
4. Creating Advocate for Health Schools (public and private) Ministry of % of Health Promoting
supportive Promoting Schools that where both learners and Education, Schools
environments empower learners and educators are empowered NHPD/
conducive to educators to undertake and adopting healthy CHSD/
health healthy lifestyle practices behaviours MOH,
Advocate and lobby with All policies by both NHPD/MOH/ % of policies (government
relevant authorities for government and private Ministry of and other sectors)
health in all policies (HiP) organizations are health Justice conducive to health that
that focus on creating promoting have been developed and /
environments that are reviewed
conducive to health such
as smoke free, disability
friendly, safe housing, clean
water and sanitation;
Collaborate with the Partnership with the NHPD/ No. of Multi-sectoral
private sector and labour/ private sector and labour/ DEOH/MOH partnership to promote
trade unions to promote trade unions to promote occupational health and
occupational health and occupational health and safety practices within the
safety practices within the safety practices developed workplace developed and/
workplace and/strengthened and strengthened and sustained
sustained
Objective 5: To establish sustainable mechanisms for gathering information on effectiveness of health promotion to inform policy and
programming
5. Fortifying Require the utilization of Health promotion messages MOH/NHPD Number of messages and Year 1-5
research and formative research that and materials are effective materials approved by
evidence- based involves the audience in in persuading audiences to MMD, and archived at the

Health Promotion the design of messages, adopt healthy behaviors MOH.
interventions materials and the
identification of the most
appropriate communication
channels to influence social
and behavioural change
outcomes.
39
40
Responsible Time -
Body Frame
5. Fortifying Monitor the implementation Progress of health MOH/NHPD, # of monitoring report
research and of health promotion promotion interventions M&E Unit available
evidence- based interventions measured against targets and partners
Health Promotion and action taken as
interventions required
Document impact of health Best practises to guide MOH/NHPD No. of documented success
promotion interventions and future health promotion stories and lesson learnt
scale up evidence-based interventions document. available.
best practices.
Objective 6: To strengthen multi-sectoral and multi-disciplinary health promotion interventions to address priority public health
conditions and disease outbreaks
6. Establishing Develop and operationalize Mechanism for a well- NHPD and Framework for risk Year 1
risk a Risk Communication coordinated timely provision partners communication at all levels
communication plan based on sound of information for pre, available.
strategies for understanding of people’s during and after disease Implementation reports
epidemics and perceptions, concerns outbreak developed and available.
priority public and beliefs as well as their operationalized.
health conditions knowledge and practices.
Strengthen mechanisms for Multi-sectoral participation MOH, CHT Reports of multi-sectoral Year
multi- sectoral participation and involvement participation in risk 1- 5
including influential citizens of stakeholders in communication and
(champions) for purposes risk communication community engagement
of advocacy and resource strengthened programs available.
mobilization for emergency

preparedness and response
Objective 7: To ensure availability of adequate resources for implementation of agreed health promotion activities at all levels
7. Instituting Advocate for dedicated Dedicated financial support % of dedicated government Year 1-5
Health Promotion budget allocation for from government for NHPD budget allocation for health
financing NHPD for health promotion for implementation of health promotion increased
across programs at promotion available
national, county, district
and community levels from
the national government
through MOH.
Develop mechanism Resources pool dedicated % resource pool with Year 1
to pool resources from to health promotion funds dedicated to health –5
development partners, established. promotion available
private sectors and other
funding agencies for
implementation of priorities
as stipulated in the health
promotion strategic plan
Lobby for innovate ways of Sin tax dedicated for the % of revenue from Sin
securing additional funding development and promotion tax dedicated to health
eg. sin tax for health of health promotion promotion available
promotion. interventions established.
Develop financial resource National health promotion National health promotion
monitoring framework financial resource Financial Resource
for health promotion framework developed. Framework available.
implementation.

GOAL: The goal of the National Health Promotion Strategic Plan (NHPSP) is to guide planning, implementation,
monitoring and evaluation of agreed health promotion actions across public health programs and sectors.
41
42
REFERENCES:
1. Annual Review Report National Health Social Welfare Plan implementation 2012-
2013
2. Country Situational Analysis MOHSW 2011
3. Demographic Health Survey 2013
4. Essential Package of Health Services primary care: the community health system
2011
5. Health Promotion Strategy for the African Region -2013
6. Investment Plan to Building a Resilient Health System (2015-2021)
7. Liberia National Population Census 2008
8. Ministry of Health and Social Welfare National Health Promotion Policy 2011
9. Ministry of Health Revised National Community Health Services Strategy and
Plan 2011-2015
10. Ministry of Health, Liberia (2015), Technical Report on The Social Mobilization
Community Engagements (RED), Under The World Bank Fund –EERP
11. National Health and Social Welfare Policy and Plan 2011-2021
12. National health communication strategy 2010 -2015
13. National Social Welfare policy 2011
14. Ottawa Charter for Health Promotion (1986)
15. Prioritizing Community Engagement to strengthen Health systems in Ebola
response. Feb 2015 www.oxfam.org/site
16. Revised National Community Health Services Policy 2011
17. R. Gladstone (2015) ‘Liberian Leader Concedes Errors in Response to Ebola’,
The New York Times, 11 March, http://www.nytimes.com/2015/03/12/world/africa/
liberian-leader-concedes-errors-inresponse-to-ebola.html?_r=0
18. Situational analysis of Newborn health in Liberia
19. WHO 2009: Milestones in Health Promotion: Statements from Global
conferences
20. WHO 2012: The global burden of disease: Update projections. http://www.who.
int/evedence/bod
21. WHO 2015: Health worker Ebola infections in Guinea, Liberia and Sierra Leone:
a preliminary report. World Health Organization, Geneva; 2015http://www.who.
int/csr/resources/publications/ebola/health-worker-infections/en/)
Suggested Citation
Ministry of Health –Liberia (2016-2021), National Policy and Strategic Plan on Health
Promotion (NPSPHP)

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3

4. KEY POLICY THEMATIC AREAS 20

5. INSTITUTIONAL ARRANGEMENT FOR IMPLEMENTATION 25

6. HUMAN RESOURCE FOR HEALTH PROMOTION 29

7. THE STRATEGIC PLAN 30

ANNEX 1: NHPD Organogram 32

ANNEX 2: TERMS OF REFERENCE FOR HEALTH PROMOTION

TECHNICAL WORKING GROUP AND SUB COMMITTEES 33

ANNEX 3: NATIONAL STRATEGIC PLAN MATRIX – 2016- 2021 34

National Policy and Strategic Plan on Health Promotion

AIDS Acquired Immuno-Deficiency Syndrome

National Policy and Strategic Plan on Health Promotion

Capacity Capacity building and strengthening is the process of equipping

National Policy and Strategic Plan on Health Promotion

Information This is the practice of communicating promotional health

National Policy and Strategic Plan on Health Promotion

National Policy and Strategic Plan on Health Promotion

Bernice T. Dahn, MD, MPH

National Policy and Strategic Plan on Health Promotion

National Policy and Strategic Plan on Health Promotion

Dr. Francis Kateh, MD, MHA, MPS/HSL, FLCP

National Policy and Strategic Plan on Health Promotion

The country is still threatened by communicable, non-communicable diseases (NCD),

National Policy and Strategic Plan on Health Promotion

National Policy and Strategic Plan on Health Promotion

1.1 Historical Background

Health is regarded by the World Health Organisation (WHO) as a fundamental

As a commitment, the government of Liberia through the Ministry of Health

1.2 The Rationale for Revising the National Policy on Health

Globally, populations and economies are grappling with Communicable diseases

National Policy and Strategic Plan on Health Promotion

1.3 The Policy Development Process and Linkages with Existing

In preparation for the development of the NPSPHP, a desk review on health

National Policy and Strategic Plan on Health Promotion

2.1 Country Profile

2.2 Overview of the health situation

Indicators LDHS 2007 LDHS 2013

National Policy and Strategic Plan on Health Promotion

Therefore, the government is focusing on building a more resilient health system

The importance of health promotion was demonstrated through the Ebola

2.3 Current Health Promotion Implementation Status

The NHPD continues to coordinate the implementation of health promotion in

National Policy and Strategic Plan on Health Promotion

2.4. Challenges and Opportunities for Health Promotion

The key challenges to health promotion in Liberia have been categorized as

2.4.1.2 Capacity - Generally, there is a paucity of qualified health promotion professionals

2.4.1.4 Funding - Government budgetary allocation for health promotion interventions is

National Policy and Strategic Plan on Health Promotion

especially in less endowed communities constrains timely and appropriate health

Government of Liberia and development partners commitment to supporting

• Supportive structures existing to protect and promote health in public and

National Policy and Strategic Plan on Health Promotion

To create an enabling environment to foster adoption and maintenance of healthy

Individuals, families and communities are empowered to make informed decisions

1. To provide a legal framework to strengthen leadership for the

3.5 Guiding Principles

The National Policy on Health Promotion is guided by the following:

• Health as a fundamental human right and sound social investment.