04/07/2026
PASHEF COMMUNIQUE
PAN-AFRICAN SURGICAL HEALTHCARE FORUM
SPECIAL FEATURE | JUNE 2026
Building the Foundation for a Healthier Liberia
Progress Toward a National Obstetrics, Anesthesia, and Surgical Plan
A Collaborative Ten-Year Vision for Universal Surgical Access
PASHeF · Special Feature
June 2026
12 min read
In the corridors of the Liberia Ministry of Health, a quiet but historic momentum is building. Across conference rooms and steering committee gatherings, a shared vision is taking shape — one that could, over the next decade, transform how Liberia delivers surgical, obstetric, and anesthesia care to its more than five million citizens. This is the story of a partnership: one rooted in compassion, driven by evidence, and grounded in the belief that every Liberian — wherever they live — deserves safe, timely, and dignified access to essential surgical care.
CapaCare, under the leadership of Country Director Dr. Marthe van den Berg, alongside Mercy Ships, represented by Regional Director Brian Holler and their dedicated teams, have joined hands with the Liberia Ministry of Health in what promises to be one of the most consequential public health collaborations in Liberia's history. Together, they are laying the groundwork for a National Surgical, Obstetrics, and Anesthesia Plan — a ten-year framework that will chart a course toward systemic, sustainable change in how Liberia prepares, trains, and delivers life-saving surgical, obstetric, and anesthesia care.
01
The Call for a National Surgical Plan
Liberia, like many countries in sub-Saharan Africa, carries a significant burden of unmet surgical need. The surgical volume in Liberia is 549 procedures per 100,000 population and remains far below the recommended target of 5,000 procedures per 100,000 population per year — a benchmark that defines the threshold for meeting a population's surgical needs according to internationally agreed standards (CapaCare et al., 2024; Meara et al., 2015). In Liberia, the challenge is compounded by a healthcare infrastructure still recovering from the devastating impact of back-to-back crises — the civil conflict of the 1990s and 2000s, the 2014–2016 Ebola epidemic, and the chronic underfunding that followed. Maternal mortality, emergency obstetric complications, traumatic injuries, and conditions requiring general surgery continue to claim lives that might otherwise be saved with timely, skilled intervention.
A National Surgical, Obstetrics, and Anesthesia Plan — commonly referred to as a NSOAP — is a government-led, multi-stakeholder framework that defines a country's commitments, priorities, and implementation roadmap for strengthening surgical systems. It addresses workforce development, infrastructure, service delivery, financing, and quality improvement in an integrated and time-bound manner. Countries that have successfully developed and begun implementing NSOAPs have seen measurable gains in surgical access, reductions in preventable deaths, and stronger health system resilience overall.
For Liberia, the development of a NSOAP represents not merely a policy ambition but a moral imperative — a statement that the right to surgical care is a right that belongs to every Liberian citizen, regardless of geography, income, or circumstance.
"The right to surgical care is a right that belongs to every Liberian citizen, regardless of geography, income, or circumstance."
02
Partnerships Forged in Purpose
The current initiative is anchored in a trilateral partnership that brings together the best of government leadership, international NGO expertise, and faith-based humanitarian commitment. At the center of this effort is the Liberia Ministry of Health, led by Minister Dr. Louise Mapleh Kpoto, a physician-administrator whose tenure has been defined by bold reform, institutional strengthening, and an unwavering focus on delivering health equity for all Liberians.
Steering the technical side of this initiative within the Ministry is Acting Chief Medical Officer Dr. Teyah Sackie Moore — a key architect of the emerging NSOAP framework. Dr. Moore has brought both technical rigor and a visionary perspective to the process, drawing on international benchmarks, regional comparisons, and Liberia-specific data to shape a plan that is ambitious yet achievable.
CapaCare, an international Norwegian NGO, is renowned for its commitment to strengthening surgical capacity in low- and middle-income countries. Through capacity building in underserved communities and the sharing of medical knowledge and skills, CapaCare contributes to the development of sustainable healthcare systems in close collaboration with local health authorities and partners.
CapaCare has conducted two nationwide surgical activity assessments in Liberia, in 2018 and 2024, and aims to repeat these assessments every five years. The data generated through these assessments are essential for informing the development of a NSOAP in Liberia. In addition, CapaCare will contribute its technical expertise and experience from supporting the development of an NSOAP in Sierra Leone to support Liberia's efforts.
Meeting with the CapaCare Liberia team at the Ministry of Health, Liberia. Discussions covered a range of issues including partnership for the development of a National Surgical, Obstetric and Anaesthesia Plan for Liberia.
Mercy Ships has extended its commitment to Liberia beyond its maritime mission. The international faith-based NGO partners with governments to deploy hospital ships delivering free, safe surgical care to populations in need. The organization also collaborates with local healthcare professionals to provide on- and off-ship education and training programs to help improve healthcare systems across Africa. The Mercy Ships team brings its vast experience in surgical capacity building, training, and infrastructure support to the partnership — recognizing that the most lasting change comes not from ships visiting shores, but from building the shore itself.
03
Early Milestones: From Vision to Structure
Progress in ambitious policy initiatives is often invisible to the outside world — measured not in grand announcements but in the steady accumulation of meetings, agreements, frameworks, and relationships built over time. This partnership is no exception. Since its inception, the collaborative team has achieved several meaningful milestones that together represent the critical scaffolding upon which the full ten-year plan will be constructed.
Formation of the National Steering Committee
One of the most important early achievements has been the establishment of a National Steering Committee, bringing together key stakeholders from across the Liberian health sector. This committee has been deliberately designed to be inclusive — drawing in representatives from clinical professional associations, academic and training institutions, national health agencies, civil society organizations, and international development partners. The diversity of the committee reflects a core principle of the NSOAP process: that ownership of the plan must be broad-based if implementation is to be sustained beyond the tenure of any single government or administration.
The Steering Committee has already begun its foundational work, reviewing templates, frameworks, and planning tools that will guide the development of Liberia's NSOAP. In the coming weeks — with a major convening planned for late June 2026 — the committee will come together to review detailed templates and reports that will form the basis of the ten-year plan. This meeting represents a pivotal moment: the transition from relationship-building and scoping to substantive technical planning.
Stakeholders coordinate through the dedicated LSOAP Steering Committee (2026–2027) group, now 21 members strong.
Engagement Meetings and Collaborative Consultations
Prior to the formation of the Steering Committee, the teams of CapaCare and Mercy Ships conducted a series of engagement meetings with Ministry of Health leadership. These consultations were structured around building a shared understanding of the vision for a NSOAP and identifying the needs and areas for support in reaching that goal. These meetings also helped establish the trust and mutual respect that are essential foundations for any long-term collaboration between government and civil society.
The partnership has been intentional about listening first. Before proposing solutions, the teams sought to understand — from the Ministry's own perspective — what a successful ten-year plan would look like, what political and operational constraints needed to be navigated, and what kind of technical and financial support would be most meaningful.
04
Learning from Sierra Leone: A Proven Model
One of the most valuable inputs into Liberia's planning process has been the experience of Sierra Leone, a neighboring country that has made significant progress in developing and beginning to implement its own national surgical plan. Sierra Leone's journey — with its challenges, innovations, and early wins — offers Liberia both a roadmap and a cautionary guide.
Acting CMO Dr. Moore has been particularly attentive to the Sierra Leone model. After a PASHeF Convening in Addis — where regional discussions on health systems strengthening and surgical care were on the agenda — Dr. Moore returned with renewed clarity and commitment. Informed by what has been accomplished in Sierra Leone and energized by the momentum of regional health collaboration, he has expressed his intent to move decisively forward with the implementation of Liberia's NSOAP, with a strong push to kickstart the project in the near term.
Sierra Leone's experience demonstrates that a national surgical plan, when properly designed, adequately resourced, and politically supported, can catalyze meaningful improvements in surgical access within a relatively short timeframe. It also illustrates the importance of maintaining multi-stakeholder engagement throughout implementation — particularly as initial enthusiasm gives way to the harder work of sustaining momentum, managing competing priorities, and adapting to evolving circumstances.
The Liberia team has developed some implementation reports and monitoring frameworks as they relate to the capacity of the Liberian health system. This is not about copying a model wholesale, but about learning intelligently from a neighbor's experience to accelerate Liberia's own progress.
"Sierra Leone's journey offers Liberia both a roadmap and a cautionary guide — and Liberia intends to learn from both."
05
The Ten-Year Framework: What to Expect
While the full NSOAP document is still under development, the broad contours of Liberia's ten-year framework are beginning to emerge. The plan is expected to address five core domains that collectively define a functional surgical system:
Infrastructure and Facilities
The plan will map existing surgical facilities across Liberia's fifteen counties, identify critical gaps, and chart a phased investment plan for upgrading operating theaters, recovery wards, blood banks, and essential equipment. Special attention will be given to district and county hospitals, which serve as the primary entry point for surgical care in rural and peri-urban communities.
Workforce Development
Liberia has a major shortage of surgeons, obstetricians, anesthesiologists, and trained surgical nurses. The NSOAP will set ambitious yet achievable targets for training, retaining, and deploying surgical personnel — including task-sharing approaches that use the skills of clinical officers and other cadres to expand access to surgical care in underserved areas.
Service Delivery and Access
The plan will establish standardized packages of essential surgical procedures that must be available at each level of the health system — from primary care to tertiary referral — along with the referral pathways, transport systems, and community awareness strategies needed to ensure that Liberians can access care when they need it.
Financing and Sustainability
A surgical plan without a financing strategy is a wish list. Liberia's NSOAP will include a detailed costing analysis and resource mobilization plan, drawing on domestic health financing instruments such as the Liberia Health Equity Fund, as well as international development assistance, bilateral partnerships, and innovative financing mechanisms.
Quality, Safety, and Data
Improving surgical outcomes requires robust data systems, clinical audit processes, and quality improvement cultures within facilities. The plan will invest in surgical data infrastructure — including the adoption of standard outcome indicators — and build the institutional capacity needed to use data for continuous learning and accountability.
06
Ministry Leadership: Championing the Vision
No national health plan can succeed without strong political leadership and institutional commitment. In Liberia, the NSOAP process has been fortunate to have exactly that.
Minister Dr. Louise Mapleh Kpoto has been a consistent champion of the initiative — signaling at the highest levels of government that surgical care is a priority, not an afterthought. Her leadership has helped create the enabling environment within which this partnership can thrive, opening doors, convening stakeholders, and ensuring that the Ministry's technical teams have the mandate and resources needed to engage meaningfully in the planning process.
Acting CMO Dr. G. Teyah Sackie Moore, together with other Ministry of Health leaders and key stakeholders — including the Policy and Planning Department — brings the medical expertise and public health perspective needed to ensure that the plan is both technically sound and clinically credible. His engagement with regional counterparts, including insights from Kigali and a review of Sierra Leone's NSOAP, has significantly strengthened the planning process. Dr. Moore's commitment to advancing implementation is a strong signal of the Ministry's seriousness and dedication to this initiative for the Liberian people.
The Ministry of Health's leadership team has shown that it can navigate the complex intersection of clinical need, political will, institutional capacity, and resource constraints that shapes health systems reform in Liberia today.
07
Looking Ahead: The Road to Implementation
The months ahead will be defining ones for Liberia's NSOAP. The late-June 2026 Steering Committee convening will be a landmark event — a moment when the work of months of preparation, consultation, and framework development comes together in a structured, multi-stakeholder deliberation. Participants will review templates and reports, provide technical inputs, and begin the process of formally endorsing the plan's architecture.
Following the June convening, the partnership anticipates entering a more intensive phase of plan finalization — incorporating feedback from the Steering Committee, commissioning supplementary analyses where needed, and preparing the full NSOAP document for formal government adoption. This process, while detailed and sometimes painstaking, is essential: a plan that is rigorously developed, widely consulted, and officially endorsed carries far more weight — and is far more likely to be implemented — than one produced quickly and without broad buy-in.
CapaCare and Mercy Ships remain committed to supporting the Ministry through every stage of this journey — from plan development through to early implementation and beyond. The relationship being built today is intended to be one that endures — a partnership built not on project timelines but on shared values, mutual respect, and a long-term vision for a Liberia where no one dies from a condition that surgery could have treated.
08
A Message of Hope and Solidarity
There is something profound about the nature of this collaboration. At its heart, it is a statement — made jointly by a national government, an international NGO, and a faith-based humanitarian organization — that the people of Liberia deserve better, and that together we have both the responsibility and the capacity to deliver it.
Surgical care has long been called the "neglected stepchild" of global health — consistently underfunded, understaffed, and undervalued relative to its contribution to the burden of disease. Liberia's NSOAP initiative is part of a growing global movement to change that — to place surgery, obstetrics, and anesthesia at the center of health systems strengthening, not at its margins.
For the women of Liberia, this initiative holds particular promise. Obstetric emergencies — hemorrhage, obstructed labor, sepsis, hypertensive crises — remain leading causes of maternal death. A strengthened surgical system means midwives and obstetricians better equipped to respond, operating theaters available around the clock, and the blood, the anesthesia, and the skilled hands needed to save a mother's life when time is critical.
For the children of Liberia, it means cleft palates repaired, hernias corrected, and childhood injuries treated before they become lifelong disabilities. For Liberian men and women of all ages, it means that a road accident, a burst appendix, or a treatable tumor is no longer a death sentence for those who cannot reach a city hospital.
This is the vision that animates the partnership between the Liberia Ministry of Health, CapaCare, and Mercy Ships. It is a vision grounded in equity, powered by collaboration, and sustained by the belief — held by everyone involved in this work — that a healthier Liberia is not only possible but within reach.
"We invite you to follow this journey with us. The road is long, but the destination is worth every step."
KEY PARTNERS IN THIS INITIATIVE
Liberia Ministry of Health — Minister Dr. Louise Mapleh Kpoto; Acting CMO Dr. Teyah Sackie Moore
CapaCare — International Norwegian surgical-capacity NGO
Mercy Ships — International faith-based humanitarian NGO
National Steering Committee — Multi-stakeholder representatives across Liberia's health sector
Published in the PASHeF Newsletter · June 2026
Pan-African Surgical Healthcare Forum
