Within the GHET Pillar II portfolio, this performance evaluation is an outcome-level study to determine the endline effectiveness of the program’s survivor-specific services. The evaluation questions are focused on whether program health services addressed the needs of Ebola survivors and were integrated into the public health system in order to mitigate the effects of further Ebola infection among the population.
Evaluation was implemented in Guinea, Liberia, and Sierra Leone. Using mixed-methods evaluation, the evaluation team drew on quantitative health facility assessments, quantitative provider surveys, qualitative key informant interviews at endline, and use of baseline and endline quantitative surveys conducted among EVD survivors by implementing partners.
Overall, the GHET program on survivor services was effective, particularly in reducing the stigma EVD survivors experienced from health providers in Guinea and Liberia. In Sierra Leone, provider stigma was already the lowest among countries at baseline and remained so at endline; thus, the same reduction was not evident. While the GHET EVD survivor program also improved the availability of clinical services for EVD survivors, accessibility of care across the continuum of care (primary to tertiary facilities) was more difficult to improve at the primary level given systemic public health weaknesses in Guinea, Liberia, and Sierra Leone.
When considering program implementation and preparation for future public health crises, the establishment of and capacity-building support to EVD survivor networks and government bodies contributed positively to the program’s efforts. However, the integration of survivor-specific services and processes into the general public health systems of Guinea, Liberia, and Sierra Leone remains a work in progress.