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Experts Call for Reforming Liberia’s Health and Education Sectors

In the wake of the October 10, 2017 presidential and Legislative elections, the Governance Commission (GC) held a three – part serial discussions/fora to enlighten the public on civic education. The Commission believed that such voter education was necessary to allow voter access to pertinent information that would inform the decisions they make come elections day.

The first forum focused on Liberia’s Education and Healthcare systems – noting the opportunities, challenges, and strengths and weaknesses of both sectors, and efforts being made, if any, to address the issues. A major highlight of this Governance Commission organized dialogue held on September 14, 2017 (at the Mamba Point Hotel in Monrovia) was the three –man - panel discussion on sub-topics “Education as it relates to 2017 and beyond”;  “Relevance of the Education system”; and “The Curative Health Care System: Who Pays?

In remarks, Commissioner Othello Gonger of the GC emphasized that voter education was cardinal in civic education because it provides an opportunity for voters to access information necessary to making informed decisions as they go out to elect their leaders at the polls. 

 Dr. Albert Coleman, Acting President of the United Methodist University (UMU) served as the Forum’s Panel Moderator. Dr. Coleman also supported the need for voter education before the October 10 elections noting that voter education is about knowing the issues so that one knows how to engage those seeking political office for the greater good.  Dr. Coleman pointed out that Education and Health are very critical issues to the development of any country and particularly Liberia.

At the same time Dr. Coleman classified Liberia’s education and health systems as national priorities needing improved support within the national budget. Dr. Coleman maintained that quality education and Health are very critical to the survival of the state. He called on Government to speed up plans geared toward building functional and manageable education and health systems - looking at them holistically and not in parts.

Dr. Coleman noted that the Ebola epidemic of 2014 exposed the vulnerability of both sectors (health and education) and wondered over national efforts at reforms to improve their performances. He wants implementation of national strategies including improved budgetary plans that support access to health and education, and enforcement of the global Sustaining development goals (SDGs) as part of Liberian government priorities.

Dr. Coleman wants government to revisit all research on Liberia’s health and education sectors and implement recommendations geared toward enhancing public services to the people and assuring an enabling environment for development in Liberia.

See education in the labor market demands: we are graduating people with no real skill to work in the labor market. We need to adjust on that. They graduate and cannot find jobs. We need to design a program that we will call “finishing school” so that graduates can be programed with skills to find job on the labor market. When we train nurses or educators, let them come out with skills that are beneficiary to the system. Don’t go to school for school sake.”

Since the cessation of violence in Liberia in 2003, leaders and critics alike have and continue to emphasize the need for improvement in the country’s health and education sectors. However both sectors continue to prove a challenge to government’s national reform initiatives.

Dr. Mator Kpangbai is Vice President for Instructional Development and Advancement at UMU, and served as a panelist at the Forum on Health and Education.  He addressed the topic “Education as it relates to 2017 and beyond”. Dr. Kpangbai noted that access to quality education has become a global struggle adding that Liberia has the opportunity to turn a new page in this global effort with the ushering in of a new government come 2018.

Dr. Kpangbai disclosed that the new Education Act of August 2011 is a major national infrastructure put together by the Ellen Johnson Sirleaf government but said this law needs the political will to support its full implementation.

On the issue of “Accreditations”, Liberia still lacks an accreditation system for institutions of Higher learning though efforts had been made in 2011 to address this issue. Dr. Kpangbai disclosed that an accreditation module was also worked on at the time with USAID promising to support the process. The process was stalled because teachers need to be tested and Curriculum updated as part of the process. There have been numerous reports relative to the qualifications of teachers and outdated teaching materials used in our schools but the excuse has been “making use of the available in the absence of the qualified (able).” Education Minister George Werner and President Sirleaf have both described Liberia’s education sector as “a Mess” though not much has been initiated to improve the sector.

According to Dr. Kpangbai Education is a science and an art and it is critical” adding that those that are prepared and able should be allowed to lead the (reform) process.

 Measurement    

Early Childhood Education (ECE) is said to be critical to the education/learning process in that it lays the foundation upon which the person (child) builds upon, and prepares the path to sustain human development. International Partners and government spend millions of dollars in primary education programs to help prepare children in their educational pursuit. Also, Dr. Kpangbai, in his presentation, urged government to place emphasis on Junior high school education. He maintains that until there is an intentional focus on junior high education our students will continue to perform poorly. He urged government to increase budgetary allotment for Liberia’s education sector.

The annual West African Examinations Council Exams have been used in Liberia to measure students’ academic performances. However, for decades now in Liberia, particularly since the cessation of hostilities in Liberia in 2003, Liberian students have and continue to perform poorly in these exams for several reasons including but not limited to unqualified teachers/teaching skills, lack of modern text books/teaching materials, students inability to grasp lessons taught, outdated school curriculum and buying/selling of grades.   

Dr. Kpanbai also flagged the WAEC exams as not being the best measurement tool to assess students’ academic performances.

There is nowhere in the world you have assumptive measurement as required as WAEC when you don’t have interim assessment in between to give, at critical grade levels, what teachers have done and what boys and girl should do. So example: if you look at the international reading standard, you will know that grade three is critical. If a boy and girl can’t read at grade three, he or she is bound to fail. You can pump as much money as you want to give, the result is fruitless.”

Dr. Kpangbai commended government for having a lot of teachers within its employ but pointed out that “there is a disconnect between what is done at the junior high level and the elementary level; and what is more alarming is also a disconnect between elementary and senior high. You can buy the text books, unless we focus on the teachers, the redesign of our curriculum to create that vertical and horizontal alignment with our curriculum and assessment we will have a lot of issues.” Dr. Kpangbai also wants Liberia’s education reform program to be robust and responsive. Despite a number of interventions, our education sector is still plague with numerous challenges.

Anthony Nimely is the Policy Advisor to the Deputy Minister for Budget and Planning, Ministry of Finance and Development Planning. He addressed the topic “Relevance of the Education system.” Mr. Nimely observed that the most important role of our education system is to build a brighter future for our nation’s students as professionals – building and assuring the nation’s human capital which serves as the backbone of developing countries and sustaining development of the economy and society.

Highlighting Liberia’s education structure and putting same into perspective, Mr. Nimely described it as 9-3-4; meaning that the structure has nine years of basic education, three years of senior secondary education, and four years of technical or vocational education. This however is expected to be preceded by two years of Early Childhood Education, ECE.

However, a number of questions and concerns remain either partially answered or unaddressed. These include:

  • What quality of learners are we producing at each of these levels within the structure?
  • Where/what is our emphasis?
  • What is the supportive link of our education system to our national development plan(s) evolving and contemporary economics in lieu of middle income status?
  • What is being done to ensure inclusivity, especially for drop-outs, those in the informal sectors, yet with potential?
  • How do we address regional disparity in all aspects of teaching and learning the same level of quality?
  • How do we reduce dropout and overage students within our school systems?
  • Free education versus the reality
  • Role of higher education institutions
  • Our post-secondary education needs to be responsive to evolving economic activities, such as hospitality sector, and other new areas within the economy.

Mr. Nimely also discussed a few sub-topics including Transition Trend Across Levels which focused on transitioning from WAEC exams to the West African Senior Secondary Certificate Examination (WASSCE) and plans to ensure satisfactory performance, and expectations.

Nimely recommended that government must:

  1. increase the inputs (quality teachers, learning materials and environment) appropriate for teaching and learning at all levels and strengthen the processes (assessments, pedagogy, and supervision among others;
  2. Pay attention to basic secondary level education;
  3. Guide students on how to benefit from professional studies - Secondary to Tertiary level;
  4. Decentralize governance/management of education;
  5. Education must be holistically supported and a-politicized

The third panelist at the Forum on Education and Health organized by GC is Miss Cecelia Morris, head of the Liberia Board for Nursing and Midwifery. She addressed the topic “The Curative Health Care System: Who Pays?

Miss Morris’ presentation painted a gloomy picture for Liberia, but placed emphasis on the need for government’s increased support to the healthcare sector and an anticipated increase in the provision of health related services to the people of Liberia.

It can be recalled that in 2014, Liberia experienced the most deadly disease outbreak in this country - the Ebola Virus Disease (EVD). The disease claimed the lives of thousands of people and left others physically and mentally scarred for life.

According to the world health organization (WHO) 2014, the Liberia health care system is ranked 186th among 190 of the world’s health system. It comes before Nigeria (187), Democratic Republic of the Congo (188), and Central African Republic (189). Despite the little gains made, Liberia’s health care system faces many Challenges which require new strategies and policies by the Health Ministry as well as effective cooperation with other sectors. 1(LIGIS 2012) 

Miss Morris provided statistics on Liberia’s fertility and growth rate and more:

The Last Official Census in 2008 placed the population of Liberia at 3.4million compared with 2.1 million in 1984. The annual population growth rate for 1984 is 3.4 to 2008 2.1 per annum. The total fertility rate in 2012 was 4.9. The percentage of the population under 18 years is 50%. Life expectancy is 60.2 years. The under 5 years of age mortality rate while still high, has decline from 220 per 1000 live births in 1986 to 110 per 1000 live births in 2007. This growth will increase the demand for essential services and facilities including health care (LIGIS 2008).”

According to Morris, Liberia is one of the poorest countries in Africa with a GDP per capital of $882. The country’s economy is largely dependent on agriculture and exports of raw material such as rubber and iron ore. She attributed the level of poverty prevailing in Liberia to a number of economic consequences as a result of many related variables.

The Liberian government, through the Health Ministry in 2007, developed the “Basic Package of health services” to prioritize and serve critical health needs and ensure access and improved health services to the Liberian people. The basic package of health services has been modified

(the current health plan 2011-2021) to include additional services such as non- communicable diseases, prison health, and neglected tropical diseases now referred to as the Essential Package of Health service (strengthening health systems to health outcomes (a UN sustainable development goal).

Miss Morris reiterated that despite government’s interventions, the health sector is still plagued with major challenges including poor quality health services due to limited number of skilled staff at health facilities, essential drugs and medical products, and funding.

“External donors and households account for the largest part of health expenditure (47% and 35, respectively), while Government spending accounted for 15%. Government spending has remained stable as a percentage of the national budget (between 7% and 8%), but it has nearly doubled in absolute terms. Donor funds are predominantly used to support service delivery at the primary care level, while referral hospitals consume the largest portion of Government expenditure.”

Other challenges noted are financing and expeditions, changing patterns of diseases, accessibility to healthcare facilities, constant supply of electricity and water to health facilities, health insurance, privatization of public hospitals, and system for health information.

According to Miss Morris, there is need to optimize access to health care facilities and professionals throughout Liberia. She disclosed that the Health Ministry indicate what she referred to as the “inadequate distribution” of  healthcare services and health professionals across this country, and therefore the need for an holistic strategy for their redistribution and organization.

On the issue of Pattern of diseases, Miss Morris noted the need for cheap health to address medical costs of communication to non-communicable chronic illnesses and diseases such as  

Diabetes, hypertension, heart diseases, and cancer. She said prevention and/or early detection is the most effective way to reduce the prevalence of chronic diseases and the cost and difficulties associated with treatment in the later stages. “Any projected reforms in the health care system must involve plans to address this change”.

The GC Executive Director Stephen Manley, in remarks noted that these GC forums are an outgrowth of the Commission’s 2017 Annual Governance Report (AGR) titled, “The Liberia Electoral System”. According to Mr. Manley, the October Elections’ campaign style was partly driven by the electorate’s expectations and candidates’ calculations of political gains. He pointed out that in popular political cultures, democracy is often understood as a right (and opportunity) to demand certain deliverables from political leaders, rather than right to participate in making decisions and searching for solutions to collective challenges.

Mr. Manley maintained that this mind set is an incentive for candidates to make unrealistic promises and undermine the reputation of political rivals. “The downside is that unrealistic promises are bound to produce disappointment later, and feed mistrust from grassroots to political elites and the state. Democracy is more than making demands on politicians. It invites citizens to define the issues they consider important and take part in the search for solutions.”

It was against this background that the Governance Commission organized the “Citizens Fora” as platforms to freely discuss and provide relevant information to voters necessary to engage and scrutinized the many candidates vying for political offices.

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