Rebuilding the Libyan health system, post-revolution
At the request of the Ministry of Health, WHO embarks on a process to design a health system that delivers essential services to the Libyan people
Libya's new Ministry of Health has moved swiftly to tackle its daunting reconstruction challenge. At the end of 2011, it asked WHO to help revitalize the country's shattered health system.
One critical problem is the lack of primary health care facilities, such as local clinics and district hospitals. Libya has less than 1 500 of these, for a population of 6.5 million. As a result, people seeking basic or routine care have to line up outside the country's specialist hospitals.
In some places, facilities were always scarce. In others, they have been badly damaged. The situation is further exacerbated by the fact that many of the foreign health workers who staffed Libya's health services fled the country during the 2011 conflict. Few have returned, creating a need for trained doctors and nurses – particularly in remote and rural areas.
The conflict has brought new health needs. As Libya's Deputy Minister of Health, Adel Mohamed Abushoffa, points out: "There are a lot of critical areas that we need to address now, for example mental health and psychosocial support. After the conflict, a lot of people need help in this area. We have a real shortage of psychiatrists. We currently have just fourteen in the whole country."
Meanwhile, there is still a chronic need for services to make pregnancy and childbirth safer and to give children a healthy start in life, alongside the ongoing need for good emergency health services.
A direct result of the lack of domestic services is that tens of thousands of Libyans are currently receiving health care abroad, which costs the Government millions of dollars per day.
Actions to rebuild the Libyan health system
The first step in the WHO support programme brought a senior delegation from Libya to WHO's headquarters in Geneva to set joint work in motion. Initial discussions focused on six fundamental action areas:
- scaling up primary health care;
- improving key aspects of health service organization;
- strengthening laboratory services;
- improving radiology services;
- enhancing drug supply management; and
- increasing the pool of trained nurses.
Health Ministry officials and WHO then sketched out some preliminary ideas as to how to achieve action in the six areas.
The next stage will be to present these ideas to colleagues in Libya. "There will be a major forum, bringing stakeholders, consumers and health authorities selected through questionnaires and meetings across Libya, to come together in a way of reconciliation and consensus-building, and agree on the most important priorities for re-engineering the health system in Libya," said Dr Samir Ben Yahmed, WHO Representative in Libya.
Dr Carissa Etienne, Assistant Director-General for Health Systems and Services at WHO welcomes the chance to help Libya. "Re-engineering a health system is a major challenge, but it is also an opportunity. An opportunity for a fresh start, to create a system which provides services that are equitable, accessible and centred around people's needs and expectations."
This is a common role for WHO. For instance in Iraq, after many years of conflict, WHO worked with the Ministry of Health to help restore health systems. Recently, for example, WHO announced the availability of rotavirus and Haemophilus influenza type B vaccines at all health care centres and launched the field implementation of the Good Governance of Medicines in Iraq.