By Foday Moriba Conteh
As part of their efforts towards exemplifying the organization’s dedication to promoting transparency, accountability and improved healthcare outcomes in the country, Health Alert-Sierra Leone, with support from Population Action International (PAI), funded by the Global Financing Facility (GFF), provided an insightful update to media representatives regarding its ongoing monitoring efforts in the realm of health service delivery in 9 districts across the country. The media brief was held on the 5th December, 2023 at the Grassroots Gender Empowerment Movement Hall on John Street in Freetown.
Addressing the Press, Dr. Victor Lansana Koroma, the Executive Director of Health Alert-Sierra Leone, emphasized the pivotal role of evidence-based advocacy and information dissemination, adding that the focus of the advocacy efforts is directed towards sexual reproductive health, family planning, and ensuring inclusivity for persons with disabilities in health service delivery.
Dr. Koroma highlighted the collaboration with key partners, including Marie Stopes International, Population Action International and the Africa Health Budget Network based in Nigeria, describing these partners as instrumental in supporting Health Alert Sierra Leone’s initiatives related to advocacy, health monitoring and budget tracking.
Providing updates on recent developments, Dr. Koroma outlined the organization’s efforts in advocating for an increase in the health budget, which currently stands at 10-11%, falling short of the desired 15%. He underscored the significance of this advocacy, stressing the need for adequate resources to address crucial health issues.
The Executive Director also mentioned the Government’s commitment to family planning, citing the signing of a compact with the United Nations Population Fund (UNFPA) for family planning commodities and essential services. Dr. Koroma emphasized the importance of holding the Government accountable for fulfilling its obligations in this regard.
He noted that the media update marks the final engagement for the year as the holiday season approaches further appealing to the Media to pay attention to the report and seek clarifications on critical areas in order to ensure accurate and comprehensive coverage.
Dr. Koroma discussed a recent extensive engagement with the Director of Emergency at the National Emergency and Health Security Directorate revealing how the discussion centered around the upcoming launch of an Agency that will be tasked with overseeing national health emergencies. Stressing the importance of investigative journalism, Dr. Koroma highlighted its role in assessing Sierra Leone’s preparedness for national emergencies maintaining that such an effort aligns with global initiatives to plan and strategize for health emergencies on a broader scale.
In his presentation on the findings, he revealed that the Project, titled “Promoting Social Accountability for Improved Health Service Delivery in Sierra Leone” has seen notable progress in various districts. Key areas of focus, he said, include Kailahun District, Tonkolili District, Western Rural District, Bonthe District, Falaba District adding that the monitoring process covers these districts as well.
He disclosed that the report discovered challenges in Bonthe Health Service Delivery Points which include lack of sea ambulance and boats for effective referrals, resulting in a major problem with seventeen maternal deaths from January to November 2023, unstable electricity supply at the District Medical Stores (DMS), posing a challenge to preserving drugs, insufficient infrastructure, including no shelves in the DMS to store health commodities from the World Bank Project, non-functional air conditioning (AC) in the drug store affecting optimal temperature, with the available one in poor condition and staffing challenges at the DMS, where most laborers are volunteers.
He added that challenges in Masingbi, Bondugu & Mile 91 Community Health Clinics (CHCs) include lack of electricity, with a nurse assisting in Health Alert’s coordination, poor water supply system in Bondugu, shared restroom for health workers and patients in Bendugu leading to hygiene issues, antibiotics and other drugs supply delay in the Bondugu ANC unit due to lack of vehicles or bad terrain.
Underscoring some of the successes at the Tihun CHC he revealed that over three years there had been no maternal deaths recorded at the facility, there has been effective immunization and outreaches conducted, staff commitment has been high despite challenges, there has been massive reduction in home and community deliveries with stable electricity supply (24 hours) etc.
Successes at Moriba Town CHC, he said, over three years, include no maternal deaths recorded, effective immunization and outreaches, high staff commitment despite challenges, massive reduction in home and community deliveries and supportive Community Health Workers (CHWs) and stakeholders.
Pointing out successes at UBC, he said, they include 562 normal deliveries conducted and 229 caesarian sections done from January to September 2023, availability of basic equipment supplied by the Government of Sierra Leone, regular monitoring visits by Health Alert-SL and Partners in Health (PIH) etc.
He lamented that the COVID-19 pandemic caused formidable challenges to public health systems globally, especially in low-income countries like Sierra Leone, adding that Civil Society Organizations played crucial roles in discussing those evolving public health issues, providing updates, and advocating for equitable vaccine access, addressing hesitancy and ensuring justice in a timely manner.
According to him, the pandemic has laid bare the vulnerabilities and disparities in healthcare systems worldwide, emphasizing the need for collaborative efforts to build resilience and address those challenges.
David Joseph Allieu, the Project Officer of Africa Health Budget Network, also shared insights into Health Alert ongoing monitoring activities related to health service delivery across nine districts in the country.
Revealing the findings in four districts, he said, for Pujehun District he expressed appreciation to Health Alert (RMNCAH Coalition) for establishing a health platform involving relevant stakeholders, underscoring positive aspects which include the availability of routine vaccination, vaccines at each PHU, and the presence of epidemiologists at both district and chiefdom levels.
For Moyamba District he expressed similar appreciation for Health Alert’s efforts, highlighting challenges which include limited community awareness of COVID-19, stock out of essential drugs, inadequate monitoring of district councils and hesitancy towards COVID-19 vaccines.
For Koinadugu District he further acknowledged Health Alert’s effort stating challenges include limited community awareness of COVID-19, stockout of essential drugs, and issues related to monitoring health service delivery.
He pointed out that common challenges identified across districts, included limited health staff, stockout of essential drugs, funding issues, inadequate equipped laboratories, poor road networks, and challenges in fuel supply for ambulance services.
As part of the report, they recommended that capacity building for local councils and DHMT staff to enhance domestic resource mobilization, increased training for health workers, improvement in fund allocation, enhanced community sensitization of the 117 emergency line in districts and vaccine uptake, maintenance of labs and equipment., timely disbursement of allocated funds, effective monitoring of service delivery systems and provision of more essential vehicles for ambulance services.
Giving the findings by districts, he said, in Kailahun District – Jojoima CHC (Sept.-Oct. 2023) positive aspects include free health care services to pregnant women, lactating mothers, and physically challenged clients with challenges including a significant number of health workers not on the Government payroll and insufficient free health care drugs.
For Western Area Rural District – Bottom Mango CHC (Sept. 2023) positive aspects include good services provided to patients with challenges including inadequate ventilation and dress code issues.
For Falaba District – Kurubonia CHC-positive aspects include spacious wards, water and light facilities and the availability of Family Planning Commodities with challenges including a damaged ANC Unit and Delivery room, needing rehabilitation.
It was pointed out that the Health Alert Sierra Leone monitoring and advocacy efforts will continue to address those challenges and contribute to improved health service delivery in the country.