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Applying the Social Determinants of Health (SDH) Framework to Liberia’s Post-Ebola Recovery Using the work of Partners in Health in southeast Liberia as an operational model Alison Herman 1 1 Department of Neuroscience, Class of 2019 2 Social factors such as politics, poverty, unemployment, and social status, which pattern morbidity and mortality. Background The focus of social determinants of health (SDH) 2 work on high income countries (HICs) produces theoretical gaps that can inhibit the thoughtful design of policy in low and middle income countries (LMICs), especially when responding to health crises unlike those seen in HICs. Existing literature deals extensively—yet separately— with the post-Ebola health systems and economic recovery efforts in Liberia. Upstream causes of the Ebola epidemic and its patterned victimization ü Colonialism ü Large-scale mining ü Economic adjustment ü Trans-Atlantic slave trade ü Community trust correlated with the number of slaves taken from region. ü History of civil war ü 354 out of 550 health centers left ü 77% of healthcare conducted by NGOs ü Foreign aid environment ü Disease-specific Evidence of SDH at work during the outbreak 1. Gender: Liberia ranked 150 out of 159 on measures of gender equality in 2015. Women account for 75% of Ebola-related fatalities. 2. Social class 3. Secondary deaths from malaria, childbirth 1. 19% increase in maternal mortality Integrating post-Ebola health systems and economic recovery efforts Economic losses totaled US$200 million. Trade routes can be used for public health purposes. Striking a balance: the work of PIH in southeast Liberia ü Social and economic support program ü Harper woodshop ü Agriculture today in Liberia Acknowledgments This work was conducted with the financial support of the Center for Health and Wellbeing as part of the International Internship Program. Cate Oswald, Brad Wagenaar, and Stephen Bezruchka provided logistical and editorial support. References located on the provided handout. Two Liberian nurses stand at the malnutrition screening center at Pleebo Health Center.
