By Foday Moriba Conteh
Plagued by one of the highest maternal mortality rates in the world, Sierra Leone, as at the 6th September, 2023, is now demonstrating unwavering determination to address the pressing issue head-on. As of 2019, a staggering 717 mothers lost their lives for every 100,000 live births in the country, according to data from the DHS (Demographic and Health Survey).
One of the key factors contributing to this grim statistic is the delayed first visits by expectant mothers to healthcare facilities. Additionally, the provision of high-quality preconception, antenatal, intrapartum and postnatal care remains uneven, further exacerbating the problem. The burden of high out-of-pocket expenses for accessing basic care, coupled with shortcomings in patient-centered care at both primary and secondary healthcare levels, compounds the challenges faced by Sierra Leone’s healthcare system.
In response to this crisis, Dr. Austin Demby, Minister of Health, has issued a heartfelt appeal to world leaders for support in the nation’s mission to reduce maternal and infant mortality. Dr. Demby passionately stated that “every case of maternal mortality constitutes an emergency” for his Ministry and emphasized that “every pregnancy counts just like every case of Ebola Virus Disease counts.” He further asserted that Sierra Leone is committed to applying the same principle to count and track every pregnancy, and despite the challenges, notable progress is being made.
The World Health Organization (WHO) is actively collaborating with other United Nations agencies and partners to provide crucial support to Sierra Leone’s Ministry of Health. WHO has extended technical and financial assistance to develop the national Reproductive, Maternal, Newborn, Child and Adolescent Health Strategy. They have also supported the adaptation and rollout of integrated obstetric care guidelines, encompassing preconception care, WHO-recommended antenatal care (ANC), as well as intrapartum and postnatal care.
The technical expertise provided by WHO has played a pivotal role in the development and implementation of safe abortion and post-abortion care guidelines, including self-care interventions for Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH). WHO has also supplied essential medical equipment and supplies, offered technical guidance for the review and update of guidelines, and trained healthcare workers to enhance access to quality emergency obstetric care.
In addition to these efforts, WHO has actively supported the Ministry of Health to fortify the maternal death notification, investigation, and response system (MPDSR). This includes the development of the Safe Motherhood and Reproductive Health Bill, which is currently under consideration in Parliament.
Sierra Leone is also in the midst of ongoing initiatives to strengthen its healthcare infrastructure and build resilient health systems. These measures involve transforming existing Hospitals and Peripheral Health Units (PHUs) to provide comprehensive patient-centered quality services across all stages of life and care. Furthermore, efforts are underway to recruit and retain skilled health personnel, empower communities, women, and girls, improve healthcare infrastructure, and address health financing mechanisms, among other vital steps.
The collective impact of these concerted efforts and comprehensive measures is beginning to bear fruit. Increasing numbers of women in communities are consistently seeking healthcare services throughout all stages of pregnancy, with over 80% of deliveries now taking place in healthcare facilities under the care of skilled birth attendants, a substantial increase from the 54% reported in 2010. The sustained expansion of these initiatives promises to have a profoundly positive impact on maternal and child health, ultimately nurturing healthier communities for generations to come.
