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Maternal Health

 

Maternal health

Every year in Sierra Leone, thousands of pregnant women lose their lives while giving birth.  An overwhelming number of these maternal deaths in Sierra Leone are due to preventable factors. At the heart of our work, UNFPA aims to end preventable maternal deaths by supporting the Government in strengthening its skilled workforce, improving health facilities, monitoring data on maternal deaths, and addressing maternal morbidity.

Reproductive, maternal, newborn, child and adolescent health is a priority for the Government of Sierra Leone. Over the years, with generous funding from UK aid, UNFPA has been supporting the Ministry of Health and Sanitation (MoHS) in strengthening Emergency Obstetric and Newborn Care (EmONC) to save the lives of mothers and newborns

Increasing and improving human resources: Midwives

Midwives play a pivotal role in providing sexual, reproductive, maternal, newborn and adolescent health care. When they are competent, confident, regulated according to global standards and provided with the enabling environment to work, they are able to effectively manage over 84 per cent of the causes of maternal morbidity and mortality in a country.

The health system in Sierra Leone has over the years recorded one of the highest maternal mortality statistics globally, with 1,360 maternal deaths per 100,000 live births.  A key national response to addressing the gap has been the efforts to improve the availability, accessibility, distribution and competency of the health workforce in order to possibly avert over 70 per cent of preventable deaths.  According to the MoHS Human Resources for Health Strategy (2017–2021), about 3,000 competently trained midwives are needed to have an impact in Sierra Leone.

In 2019, with funding from the Saving Lives in Sierra Leone Programme of the UK’s Department for International Development (DFID), UNFPA supported the recruitment, tuition, subsistence, procurement of teaching learning materials and supportive supervision of 120 new midwifery students for a two-year training programme at two midwifery schools located in Bo and Makeni districts. At the end of the year, a total of 98 midwives graduated from these schools and were all deployed to health facilities in the 16 districts to provide much needed quality maternal and newborn services.

Commissioning of CEmONC facilities

UNFPA, with funds from UK aid, and in collaboration with the MoHS, completed the construction of two new maternal and child health hospitals namely Rokupa Hospital and King Harman Hospital. Prior to this, there was only one facility providing maternal and child health care in the entire country. Both hospitals were supplied with equipment and furniture essential to the provision of maternal, newborn and child health services. The hospitals, commissioned by the Vice President and President of the Republic of Sierra Leone respectively, are providing much needed quality maternal, newborn and child health care to the people of Sierra Leone and will contribute to the reduction of morbidity and mortality in mothers, newborns and children.

Supporting qualtiy improvement

In partnership with Doctors with Africa CUAMM, UNFPA supported the delivery of quality CEmONC services in three regional hospitals: Princess Christian Maternity Hospital, Bo Government Hospital and Makeni Government Hospital. Through this support, the hospitals benefited from in-house expert obstetricians and midwives who also provided on-the-job training for local staff. Equipment, supplies and buffer stock of essential maternal health medications were distributed. Quarterly blood campaigns were conducted and support was given to regular blood donors. As a result of these contributions, in 2019, 14,539 women and girls directly benefited from interventions to manage direct obstetric complications, of which 4,696 were caesarean sections. The results were evident with a clear reduction of the direct obstetric case fatality rate from 2.18 per cent to 1.25 per cent. All maternal deaths which occurred in these hospitals were audited and recorded and the recommendations were used to strengthen the quality of care in these facilities. Over 200 doctors from the three hospitals were also trained in various aspects of EmONC to enable them to provide quality services. Additionally, the doctors were trained in quality improvement methodologies to enable them to provide improved services to women and girls.

 

[1] World Health Organization, ‘Strengthening quality midwifery education for Universal Health Coverage 2030: framework for action’, Geneva, 2019.