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At a glance: Sierra Leone

Sierra Leone targets child and maternal mortality

© UNICEF Sierra Leone/2006/Savage
Sinnah Kamara smiles brightly, holding her daughter after the child’s immunization at a health centre in Binkolo. More than a quarter of Sierra Leone’s children do not reach their fifth birthday, mainly as a result of easily preventable diseases.

By Yves Willemot and Alusine Savage

BOMBALI DISTRICT, Sierra Leone, 11 July 2006 – Sinnah Kamara is a young mother in Binkolo, located in northern Sierra Leone’s Bombali district. Although she has two healthy children, she knows how fragile the survival chances of children are in her country. 

“My sister lost a boy of two years old due to malaria, and I have seen many children die of measles and tetanus,” she says. “Most families in Sierra Leone have in one way or another been confronted with the death of a child from an easily preventable disease such as measles, diarrhoea, pneumonia or malaria.”

Sierra Leone has the second-highest child mortality rate in the world, behind Niger. A recent survey by the government and UNICEF confirms that more than one child out of four does not reach his or her fifth birthday. 

In its efforts to reduce that rate and assist the country in meeting its Millennium Development Goals, UNICEF – in collaboration with the World Health Organization, the European Union, the World Bank and the Department for International Development – is supporting a national integrated child survival and development programme.

The initiative includes immunization, vitamin A supplementation, prevention of mother-to-child HIV transmission, the distribution of insecticide-treated bed nets to fight malaria, home-based newborn care, promotion of exclusive breastfeeding, oral rehydration and treatment of paediatric AIDS.

© UNICEF Sierra Leone/2006/Savage
Mother and child make use of a mosquito net provided by the Maternal and Child Health division at the Bombali Bana health centre in Sierra Leone.

Building blocks of child survival

More than aware of the risks facing infants, Ms. Kamara regularly seeks advice from the health centre in Binkolo for her 18-month-old daughter, Sally.

The Binkolo peripheral health centre is one of the building blocks of the child survival and development strategy in Sierra Leone. The centre coordinates all health and nutrition programmes in seven chiefdoms in the Bombali district, reaching about 24,000 people with help from local and traditional leaders who have joined the Chiefs as Champions for Children Initiative.

The centre’s work on child nutrition is critically important, since malnutrition is a major underlying cause of infant deaths in Sierra Leone.

“Children facing moderate malnutrition are sent to the health centre for complementary feeding whilst cases of severe malnutrition are sent to the therapeutic feeding centre in Makeni,” says Angela, a health worker at the outreach centre at Bombali Bana. “Currently, there is only one centre for the whole district, far too little to meet the need.”

Stimulus for mothers

Maternal and child health aides and the traditional birth assistants at the centre monitor the growth of babies and encourage exclusive breastfeeding and good hygiene, as well as immunization against preventable diseases.

At the third immunization round, when children reach their fourth month, every mother gets an insecticide-treated bed net for her child. 

“Giving a bed net at the fourth month is an extra stimulus for mothers to come back to the health units to vaccinate their children,” notes Angela. “It coincides with the time when mothers start thinking about putting their children to sleep in a separate bed.”



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