It is safe to say that the infrastructure around health in sub-saharan African countries is a work in progress.
In Sierra Leone especially, the maternal mortality rate was estimated to be the world’s highest in 2015, at 1360 maternal deaths per 100,000 live births. And in 2018, it was found that women in Sierra Leone have a 1 in 7 life-time risk of dying due to pregnancy or childbirth, and maternal deaths account for 36% of all deaths among women aged 15–49.
This is largely because their health sector severely deteriorated during the civil war, from 1991-2002. As a result, many places in the country were left without adequate aid or support, which meant a lowering of life expectancy to 58.61, and it being a very unsafe environment to be pregnant in.
What didn’t help is that during the war, there was an influx of donor funds into the health sector, but there were no central coordinating mechanisms to ensure accountability. There were also no strategies put in place to ensure the sustainability of the health services.
Unfortunately, after the war finished, these NGOs did not put in place an exit strategy to sustain health service provision in their previous operational areas, either.
However, since the early 00’s there have been many strategies and programmes put in place in Sierra Leone in order to build up their health system, by both their government and larger organisations.
In 2004, Sierra Leone adopted the Integrated Diseases Surveillance and Response (IDSR) strategy. The country successfully rolled out IDSR in all government health facilities and some private and religious facilities. This enabled them to deal with outbreaks of communicable diseases much more easily, as they could monitor them and respond accordingly.
In terms of pregnancy and maternal care, the government made reducing maternal mortality a priority via the Free Health Care Initiative, which was introduced in 2010. It favoured pregnant and lactating mothers and has increased women’s right to health care services throughout the country. This initiative was aimed at improving access to care and availability of lifesaving commodities.
In more recent years, 2018 in particular, Sierra Leone saw remarkable progress in the health sector. Major milestones have been achieved in improving reproductive, maternal, child, and newborn health.
Sierra Leone is now one of 10 countries participating in the Global Network for Improving Quality of Care for Mothers, Newborns and Children.
The country has also developed a four-year Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) strategy 2017–2021 with the aim of significantly reducing maternal and child mortality.
Many of these programmes have been created with help from the World Health Organisation, and they specifically supported the training of 30 nursing and midwifery teachers through on-the-job coaching in CBE methodology and skills in 2018.
Life for African Mothers
Another organisation actively helping mothers in Sierra Leone and elsewhere is Life for African Mothers. LFAM was founded in Cardiff in 2006 by former neonatal nurse Angela Gorman, originally to support Dr Grace Kondido working with pregnant women in Chad.
Now, the charity works with people on the ground in several different countries to provide training to midwives, nurses and other healthcare workers in sub Saharan Africa.
This is often in the form of skills sharing workshops tailored to the requirements of the individual countries. These countries are Liberia, Somaliland, the Democratic Republic of Congo, and Cameroon (in addition to Sierra Leone). Many of these countries have similar barriers restricting access to healthcare as Sierra Leone does, like civil war, extreme poverty, and lack of needed medicine.
In addition to the workshops, LFAM also provides Misoprostol, which is a medicine that helps to prevent postpartum hemorrhage, as one third of worldwide maternal deaths are caused by it.
The condition is managed more effectively in countries where blood banks are common and well-stocked, and where there is a ready supply of Oxytocin. However, Oxytocin has to be refrigerated at a very specific temperature, which makes it difficult to store in hot countries. Where this treatment is not possible, Misoprostol is used.
LFAM has been very successful, as their partners reported a fall in both the maternal mortality rate and the number of caesarean sections in the two districts in Sierra Leone that were provided workshops in 2019.
At the Oxford Health Company we believe that health should be accessible to everyone, which is why, this spring, we decided to work with Angela and Life for African Mothers.
We donated 1000 bottles of our new Pregnancy Care Extra supplements, which have been received in Sierra Leone by Morlai Kamara, who works with LFAM.
The Pregnancy Care Extra formula contains many important vitamins and minerals, including Iron, Magnesium, Selenium, Vitamin C, Vitamin D, Vitamin E, and B Vitamins 1, 5, 6, and 12. These nutrients provide excellent support for pregnant women, as collectively they contribute to the immune and nervous systems, plus reduce tiredness and oxidative stress.
Since malnutrition is another major issue facing pregnant women in Sierra Leone and the other countries mentioned, we hope that providing these extra nutrients will be extremely beneficial to them.
1) NAHPS Executive Summary [Internet]. Freetown: Ministry of Health and Sanitation, Government of Sierra Leone; 2019 [cited 1 June 2021]. Available from: https://www.afro.who.int/sites/default/files/2019-10/NAPHS%20EXECUTIVE%20SUMMARY%202018-2022-SMALL%20FILE.pdf
2) Country Situation Analysis - Sierra Leone [Internet]. ReBUILD Consortium; 2014 [cited 1 June 2021]. Available from: https://assets.publishing.service.gov.uk/media/598af21840f0b619c913108f/country-situation-analysis-sierra-leone.pdf
3) WHO Sierra Leone 2018 Annual Report [Internet]. Freetown: WHO Sierra Leone Country Office; 2019 [cited 1 June 2021]. Available from: https://www.afro.who.int/sites/default/files/2019-09/WHO%20Sierra%20Leone%202018%20Annual%20Report.pdf
4) Charity [Internet]. Lifeforafricanmothers.org. 2021 [cited 1 June 2021]. Available from: https://www.lifeforafricanmothers.org/