Vera G. Mussah is the Manager for Performance-based Financing at the Ministry of Health of Liberia.

What is your current position?

I have been the Manager for Performance-based Financing in the Ministry of Health in Liberia since October 2015. I took on this post because I wanted to focus on managing specific programs, understanding the dynamics, and I considered performance-based financing a new approach to improving healthcare delivery systems. I have a staff of five working in my office, and we provide direct oversight to five counties in Liberia. United States Agency for International Development (USAID) supports this project. The project began in 2012 in three counties with a few primary healthcare facilities through an NGO to rebuild basic health services and expand essential services using this mechanism. This helped us to motivate the health workers to provide quality maternal, newborn and child healthcare; as well as promote accountability and transparency through a decentralized health system. The program is now part of the Ministry of Health. With the Ebola outbreak, this program was put on hold, and we are now trying to restart it.

Can you tell us about your career path?

I earned my bachelor’s degree in nursing. I then began my career at one of the Government of Liberia’s health facilities in Grand Cape Mount County, in a rural setting, as one of two professional nurses. The health center was providing health care only in the daytime, so cases at night would go unattended. My colleagues and I changed this to make it a 24/7 health center, and our patient load increased. I was also in charge of overseeing the drugs at the health center, and preventing stock-outs. Following my participation at a Gender-based violence training workshop, where I was represented my facility, an NGO recruited me to work on a gender-based violence program for 2 years. I left for a four-month fellowship on human rights and HIV at the UN human rights commission office in Switzerland and returned to work with the NGO on gender-based violence and refugee health issues upon my return. I was selected to participate in a six-week prestigious Mandela-Washington fellowship for young African leaders, at the Andrew Young School of Public Policy in Atlanta, Georgia.

I earned my masters in International Public Health from the University of Queensland in Australia in 2012 and returned to Liberia. I consulted for a non-profit organization providing preventive services and worked with the project staff to design a monitoring and evaluation framework for four months. I moved onto the Ministry of Health of Liberia in 2013. My initial role at the Ministry of Health was Capacity Building Coordinator, to make sure operations in the different counties had the right staff, training, supplies and logistics. I worked with international consultants to develop a policy-oriented strategy for capacity building in Liberia. I later served as Coordinator for the County Health Services Unit as a point person for county operations and guided the development as well as implementation of quality health standards. I also provided oversight on prison health services within the Unit. 

During the Ebola outbreak, I was part of the Ministry’s case management group. I led the case investigations; I would receive calls for cases reported, then dispatch a group to respond to the cases in different counties. It was our job to make sure patients were isolated and taken care of and to prevent the spread from individual cases. I saw many patients die; I lost many colleagues too. We went through very difficult times.  I also led the health services department to restore routine health services and support the establishment of a public health institute in Liberia.

Can you share your top career goal?

I will continue to advocate for an improved healthcare system in Liberia. I believe that low- and middle- income countries can only survive if their governments commit to appropriate and adequate budgetary allotment for health care. We can’t continue to significantly rely on donors to support our national development. We have to be accountable and commit ourselves to providing the basic social services, including health, to our citizens. I want to help make government more responsive and accountable to providing citizens with basic social services, through legislation of laws and acts. That’s my goal. I want to see a Liberia healthcare delivery system where when you come to visit me as a tourist, you don’t have to worry about being taken care of. I want to see health facilities that are well equipped, where you can go for care and you feel comfortable and you know that the environment has helped you to get well. I want to see Liberians more into research, sharing their own stories, writing our stories. I want to continue to advocate for all of these things. I will not relent.

What is the biggest challenge you face?

Resistance from people who are not ready for change, within the work place. Sometimes colleagues do not have the same vision as you, and it becomes political. This can be challenging.

What impact do you think GHDI will have on your career?

One of the best things that have happened to me in recent times is participating in this program. I had a completely different idea of what the program would be, but it exceeded my expectations entirely. It made me think differently about how to deliver health, not just in Liberia, but in the world. For example, if Liberia  is  having  one  problem,  China  and  Botswana  are  having  the  same  problem,  and  we  are  all colleagues, we are like a family. We can help each other, share ideas, email, visit each other, see what worked in one country and try to adapt it to the other country’s health system to solve a similar problem. I am happy that I can always refer to the online community and all of the resources and use them to transfer my knowledge to others on my team and in the ministry who can benefit from it. The GHDI course is very intensive but very rewarding.

What are you most proud of?

I’m proud that I could contribute to reducing or eliminating incidence of Ebola in Liberia. I am proud of helping to develop health system plans for Liberia. I’m proud that I am able to contribute in some way to the health and wellbeing of Liberians. I’m proud of encouraging my friends and colleagues to go back to school and finish their education. And I’m proud to be here, in this program.

What advice would you give to someone just starting out in health care in your country?

You have to be open-minded. You have to leave room for discipline. Accept things, and love, and breathe, and just be opened. Be a team player and give everyone the opportunity to contribute to the effort with the abilities they have. Don’t confine yourself to a specific idea or job or organization, and don’t be afraid to take new opportunities with challenges and see where they may lead.