Implementation of the Ebola response was credited with reducing incidence of Ebola virus disease (EVD) in West Africa; however little is known about the amount and kind of Ebola response activities that were ultimately successful in addressing the 2014 outbreak. We collaboratively monitored Ebola response activities and associated effects in Margibi County, Liberia, a rural county in Liberia deeply affected by the outbreak. We used a participatory monitoring and evaluation system, including key informant interviews and document review, to systematically document activities, code them, characterize their contextual features, and discover and communicate patterns in Ebola response activities to essential stakeholders. We also measured incidence of EVD over time. Results showed a distinct pattern in Ebola response activities and key events, which corresponded with subsequent decreased EVD incidence. These data are suggestive of the role of Ebola response activities played in reducing the incidence of EVD within Margibi County, which included implementing safe burials, social mobilization and community engagement and case management. Systematic monitoring and evaluation of response activities to control disease outbreaks holds lessons for implementing and evaluating similar comprehensive and multi-sectoral community health efforts.

Although credited with ultimately reducing incidence of Ebola Virus Disease (EVD) in West Africa, little is known about the amount and kind of Ebola response activities associated with reducing the incidence of EVD. Our team monitored Ebola response activities and associated effects in two rural counties in Liberia highly affected by Ebola. We used a participatory monitoring and evaluation system, and drew upon key informant interviews and document review, to systematically capture, code, characterize, and communicate patterns in Ebola response activities. We reviewed situation reports to obtain data on incidence of EVD over time. Results showed enhanced implementation of Ebola response activities corresponded with decreased incidence of EVD. The pattern of staggered implementation of activities and associated effects-replicated in both counties-is suggestive of the role of Ebola response activities in reducing EVD. Systematic monitoring of response activities to control disease outbreaks holds lessons for implementing and evaluating multi-sector, comprehensive community health efforts.

ThrYve supported cross-sector collaboration involving over 40 partners across 13 community sectors. • A total of 87 change levers were identified to support community and systems-level improvements. • Additionally, 85 community actions and changes were implemented based on identified needs of youth. • ThrYve supports a comprehensive, multicomponent, approach to youth violence prevention. • Youth can be meaningfully engaged in community change initiatives through participatory approaches.

To address the Ebola outbreak in West Africa, the World Health Organization and the United Nations Children’s Fund led a multilevel and multisectoral intervention known as the Ebola response effort. Although surveillance systems were able to detect reduction in Ebola incidence, there was little understanding of the implemented activities within affected areas. To address this gap, this empirical case study examined (a) implementation of Ebola response activities and associated bending the curve of incidence of Ebola virus disease and (b) candidate factors associated with fuller implementation of the Ebola response effort. A mix of qualitative and quantitative methods were used to address these questions. A participatory monitoring and evaluation system was used to capture, code, characterize, and communicate nearly a hundred Ebola response activities implemented in Lofa County, a highly affected area in Liberia. The Ebola response effort was enabled by community engagement and collaboration across different sectors. Results showed fuller implementation corresponded with a marked reduction in Ebola virus disease. This report concludes with a discussion of how monitoring and evaluation can strengthen implementation of activities needed to address disease outbreaks.

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