Liberia Field Epidemiology Training Program
Program overview
The Liberia Field Epidemiology Training Program (LFETP) began in August 2015. The program is funded by the U.S. Centers for Disease Control and Prevention (CDC) and implemented by the African Field Epidemiology Network (AFENET). Emory University was instrumental and directly involved in standing up and implementing the program for the first year of LFETP’s existence.
The LFETP resides in the National Public Health Institute of Liberia (NPHIL) and is linked closely to the Division of Infectious Disease Epidemiology (DIDE) and Division of Training and Capacity-Building. The Director of DIDE serves as the Program Director for LFETP. Most LFETP trainings are conducted in the Training Unit of NPHIL.
LFETP has two levels: FETP-Frontline and FETP-Intermediate. Over the past two years, seven LFETP-intermediate graduates have enrolled in the Advanced FETP in Ghana. The LFETP has trained medical, environmental, laboratory and animal health personnel from the NPHIL, MOH, and the Ministries of Interior, Agriculture and Defense. In 2021, the program introduced the Executive FETP, a six-week training package targeted at supervisors of surveillance officers, and designed to equip the participants to understand their role in supporting the implementation of the Integrated Disease Surveillance and Response.
As of October 2021, the LFETP has graduated 270 persons in 12 cohorts at the frontline level and 62 persons in four cohorts at the intermediate level. There are 18 participants in the current Intermediate Cohort 5 (scheduled to graduate in December 2021). Fourteen Medical Directors of major health facilities graduated as the first cohort of the Executive FETP.
Achievements
LFETP graduates play key roles in outbreak investigations and response at the national, county and district levels, including Ebola Virus Disease outbreaks in Montserrado County (2015), meningococcal outbreaks in Sinoe County (2017) and Lofa County (2018), and the COVID-19 pandemic (2020). In all these potentially devastating outbreaks, early detection and reporting, and extensive contact tracing and monitoring by LFETP Frontline and Intermediate graduates were instrumental in helping to contain them.
Review of surveillance data from Liberia weekly disease bulletins showed an improvement in timeliness and completeness of surveillance reporting at all levels since FETP trainings began in the country. Timeliness and completeness have remained above target since 2016. In the second half of 2017, the NPHIL reported a steady improvement in the timeliness of responding to health emergencies and outbreaks. Among 20 outbreaks investigated and responded to in that period, 90 percent were documented with investigation reports compared to 53 percent in 2016; 78 percent were responded to within 48 hours compared to 37 percent in 2016.
LFETP participants and graduates have made presentations at international conferences in Nigeria, Ghana, Thailand, the United States, and Mozambique. Together with NPHIL, LFETP has successfully organized two annual scientific conferences in Liberia. In addition, the program has organized two batches of scientific writing, out of which at least 40 articles have been submitted or are being developed for publishing. The LFETP also facilitated the establishment of Liberia Research Clubs at tertiary institutions in the country to build interest and capacity in scientific research. Findings from the Intermediate Cohort 2 study, a knowledge, attitudes, and practices (KAP) study on Lassa fever among adults in Liberia, guided the development of the Lassa Fever Response Plan for Liberia. In response to the FETP-Intermediate Cohort 3 group project that found poor knowledge about Integrated Disease Surveillance and Response (IDSR) among clinicians in Monrovia, LFETP partnered with the University of Liberia’s A.M. Dogliotti Medical School to conduct public health and IDSR training for all fourth-year medical students.