655 - Reviving Pediatric Care in Liberia: Building a Sustainable Residency Training Program for Future Generations

Publication Number: 3634.655

Patricia A. McQuilkin, Boston Children's Hospital, Harvard, MA, United States; Roseda E. Marshall, John F. Kennedy Medical Center, Pikesville, MD, United States; Elinor A. Graham, Retired, Seattle, WA, United States; Readon C.. Ideh, JFK Medical Center, Monrovia, Montserrado, Liberia; Magdalene Erhieyouvbe. Odunvbun, University of Benin/University of Benin Teaching Hospita, Benin City, Edo, Nigeria; Michelle Niescierenko, Boston Childrens Hospital, Boston, MA, United States

Background: Liberia, a West African country, faced a devastating civil war from 1989 to 2003 that severely damaged its medical infrastructure and training systems. At the war’s end, only 50 physicians remained, and there were no pediatricians to care for a population where over 40% was under 14 years old, compounded by some of the highest neonatal and under-five mortality rates globally. In 2013, the Liberian government established the Liberia College of Physicians and Surgeons (LCPS) to rebuild medical training in key specialties, including pediatrics.

Objective: To describe the development, implementation, and outcomes of Liberia’s first pediatric residency program; evaluate graduate distribution and professional advancement; and assess progress toward equitable pediatric care nationwide.

Design/Methods: The pediatric residency program was a collaboration between the Ministry of Health (MoH), LCPS, the West African College of Physicians (WACP), and Boston Children’s Hospital (BCH). Funded by the World Bank, the MoH contracted BCH to manage the program, recruiting regional WACP fellows as faculty. BCH provided three general pediatric faculty for one-year placements and six subspecialty faculty for short-term assignments. The curriculum followed the WACP framework, with JFK Memorial Hospital in Monrovia serving as the main training site.

Results: Since 2013, the program has graduated 23 pediatricians. Of these, 4 have become WACP fellows and now serve as faculty at the national referral hospital, 17 continue in clinical practice, and 5 hold administrative positions within the MoH ,setting national child health policies and 1 works with LCPS. Fourteen graduates work at public hospitals in Montserrado County, the most populous region, while three are placed in outlying counties. The goal is to have at least one residency-trained pediatrician in each of Liberia’s 15 counties. Developing Liberian pediatric faculty remains key to sustainability; to date, 5 graduates have achieved fellowship status, qualifying them as local faculty.

Conclusion(s): This sustainable pediatric training program has produced 23 qualified pediatricians now strengthening pediatric care across Liberia. Strategic placement of graduates in county hospitals—previously staffed by general medical officers—is improving access to specialized child health services. The program offers a scalable model for post-conflict health system rebuilding through regional collaboration, standardized training, and locally led faculty development.