Through much of 2014 and into 2015, the international community witnessed an outbreak of Ebola virus disease in parts of West Africa that was unprecedented in scale, severity and complexity. The toll in illness and death was severe: more than 28,000 people were infected and more than 11,000 died. Some 16,000 children lost parents or caregivers to Ebola.
The impact of the outbreak went far beyond those grim figures. The three most-affected countries – Guinea, Liberia and Sierra Leone – were ill-equipped to respond.
As a result, the outbreak wrought serious humanitarian, economic, development and health consequences. Livelihoods were disrupted, fragile health systems were severely compromised and entire educational systems were either shut down or school openings delayed.
The outbreak revealed serious deficiencies in national and global response mechanisms aimed at controlling potential pandemics. It took the greater part of 2014 for the national and international response to help bring the outbreak under control.
The outbreak was ultimately contained thanks to efforts of affected communities themselves, local leaders and the massive deployment of international resources.
This report presents results from an evaluation of UNICEF’s response to the crisis. It documents and analyses UNICEF efforts, drawing out important lessons to prepare and strengthen UNICEF’s approach to addressing future public health emergencies.
UNICEF country offices began responding to the Ebola outbreak in early 2014. In early September, a corporate-level emergency was declared, under which, in coordination with many partners, UNICEF mobilized an agency-wide response to the crisis. The response was sustained through 2015.
This report sets out the findings, conclusions and recommendations of an evaluation of UNICEF’s response to the Ebola outbreak in West Africa. The evaluation served an accountability function and enabled stakeholders to offer feedback; it supported organizational learning by identifying key lessons for UNICEF; and it prompted strategic consideration by providing recommendations to UNICEF on preparing for future public health emergencies.
The evaluation drew on a wide range of other learning exercises and assessments.
To complement these, the evaluation focused selectively on the strategic challenge of coordinating UNICEF’s levels, programmes and operational functions (i.e. how these elements combined to deliver an effective response). As such, it does not provide detailed information or a technical assessment of implementation.
The evaluation found that UNICEF and partners made useful contributions to stopping Ebola transmission and that those contributions depended foremost on the organization’s innovative community-based implementation model, participation in the larger international public health response with national governments, and the mobilization of corporate capacities through the Level 3 Simplified Standard Operating Procedure resource management functions.
However, the impact of these contributions was diminished by important factors. These include missed opportunities for containing the outbreak in March 2014, delays in operationalizing the community-based response, differing understandings of the rationale for intervention and weaknesses in performance management and monitoring systems. Moreover, UNICEF was challenged in its efforts to promptly and adequately address Ebola’s secondary humanitarian consequences and specific effects on children.
The Ebola epidemic in West Africa was a grim reminder of the stark threat posed to humanity by communicable diseases. In the aftermath of the outbreak, there is widespread agreement that such threats will continue to arise from time to time. Drawing on the key findings from this evaluation, the recommendations presented in this report are therefore primarily focused on how UNICEF can be better prepared and capacitated to deal with future health emergencies.
The evaluation was conducted by a team headed by Andrew Lawday, and including Kerren Hedlund, Nigel Clarke, Steve Powell, Annie Lloyd, Tamba Emile Sandounou, Lynn Owen, and Alistair Hallam. It benefited from information, perspectives and feedback provided by UNICEF colleagues in the Guinea, Liberia and Sierra Leone UNICEF country offices, the UNICEF West and Central Africa Regional Office in Dakar, Senegal, as well as UNICEF Headquarters. The Evaluation Reference Group provided important contributions and guidance throughout the process. Finally,
I would like to recognize Beth Plowman, who served as Evaluation Manager with support provided by Abdoulaye Seye.
We would also like to acknowledge the contributions made to this evaluation by staff in partner organizations, as well as by national officials and community members who shared their stories with the evaluation team. They gave time and attention to the evaluation during a period of enormous stress and pressure. We hope that the results of the evaluation are used to prevent or contain similar emergencies in future years, and to alleviate the concomitant loss and suffering experienced by those affected.
Director, Evaluation Office