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Publication
Strengthening Post-Ebola Health Systems: From Response to Resilience in Guinea, Liberia, and Sierra Leone
(Washington, DC: World Bank, 2018)Strengthening Post-Ebola Health Systems addresses the challenge of enabling the development of viable, resilient, and fiscally sustainable health system in Guinea, Liberia, and Sierra Leone. Initiated while Ebola was still raging in all of the three most-affected countries in West Africa, it identifies the requirements for strengthening the health systems in these countries to go beyond just getting the number of Ebola cases to zero. The overall goal of this study is thus twofold: To assess the capacity of the health systems of the three most-affected countries in terms of their ability to deliver quality health services to their populations, perform core public health functions on a routine basis, and to respond to public health emergencies; and To identify the highest impact strategies to help these countries to strengthen their health systems to be more effective and resilient, drilling down into three key aspects of the health system--that is, fiscal space for universal health coverage (UHC), development and deployment of an effective health workforce, and continuous disease surveillance. -
Publication
The Economic Impact of the 2014 Ebola Epidemic : Short- and Medium-Term Estimates for West Africa
(Washington, DC: World Bank, 2014-11-20)Beyond the terrible toll in human lives and suffering, the Ebola epidemic currently afflicting West Africa is already having a measurable economic impact in terms of forgone output; higher fiscal deficits; rising prices; lower real household incomes and greater poverty. These economic impacts include the costs of healthcare and forgone productivity of those directly affected but, more importantly, they arise from choices by others to avoid exposure to the disease, called 'aversion behavior'. This report provides a systematic analysis of the channels of economic impact and the likely magnitude of that impact for Guinea, Liberia, and Sierra Leone, as well as West Africa as a whole. The short-term (2014) impact of Ebola on economic output is on the order of US$359 million in foregone output in 2013 prices. Two alternative scenarios are used to estimate the medium-term (2015) impact of the epidemic. A 'Low Ebola' scenario corresponds to rapid containment within the three most severely affected countries, while 'High Ebola' corresponds to slower containment in the core three countries, with some broader regional contagion. The estimates of the GDP lost as a result of the epidemic in the core three countries for 2015 alone sum to US$97 million under Low Ebola (implying some recovery from 2014), and US$809 million under High Ebola (in 2013 dollars). Over the medium term, however, both epidemiological and economic contagion in the broader sub-region of West Africa is likely. This report uses a multi-country general equilibrium model to estimate the medium-term impact on output for West Africa as a whole. Under Low Ebola, the loss in GDP for the sub-region is estimated to be US$2.2 billion in 2014 and US$1.6 billion in 2015. Under High Ebola, the estimates are US$7.4 billion in 2014, and US$25.2 billion in 2015. This analysis shows that the economic impacts are already very serious in the core three countries - particularly Liberia and Sierra Leone - and could become catastrophic under a slow-containment, High Ebola scenario. In broader regional terms, the economic impacts could be limited if immediate national and international responses succeed in containing the epidemic and mitigating aversion behavior. If, on the other hand, the epidemic spreads into neighboring countries, some of which have much larger economies, the cumulative two-year impact could reach US$32.6 billion by the end of 2015 - almost 2.5 times the combined 2013 GDP of the core three countries. -
Publication
Youth Employment in Sierra Leone : Sustainable Livelihood Opportunities in a Post-conflict Setting
(World Bank, 2009)This study focuses on short- and medium-term solutions. It informs the government about the type of programs and policies that could improve the employability of young people, paying special attention to areas in which productivity can be rapidly improved. The report consists of six chapters. Chapter two profiles young people in Sierra Leone. Chapter three examines young people in the labor market, with a focus on the labor supply side of the equation (that is, the skills young people bring to the labor market). Chapter four turns to employers (the demand side of the labor market) to better understand why they do or do not employ young people. Chapter five reviews skill development programs to enhance employability of young people in Sierra Leone and other countries and presents policy options for improving worker skills (supply side) and employer interest (demand side). Chapter six summarizes the lessons from the analysis and concludes with policy and program recommendations.