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At a glance: Sierra Leone

Reducing the dangers of pregnancy in Sierra Leone through free women's health care

'Healthy Women, Better World' – Tracking maternal, newborn and child survival

© UNICEF Video
Hawa Barrie recovers in Bo Government Hospital, Sierra Leone, after giving birth to her son while she was suffering from eclampsia, a life-threatening complication of pregnancy.

UNICEF and other international leaders in maternal health and child survival are meeting in Washington, DC, to accelerate a global campaign aimed at reducing deaths of pregnant women and young children. Here is one in a series of related stories.

BO, Sierra Leone, 7 June 2010 – In late April, just after her baby boy was born at Bo Government Hospital in southern Sierra Leone, it was by no means certain that Hawa Barrie would survive to raise him. Ms. Barrie, 40, was suffering from eclampsia, a pregnancy-related complication characterized by seizures and convulsions.

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Sister Affiong Inyang, the nurse attending Ms. Barrie, said the new mother was in stable condition but would be monitored at the hospital before being sent home. "For now her blood pressure has gone down because the baby has been delivered,” she explained.

Dangers of pregnancy

Sierra Leone is one of the most dangerous places on earth to be pregnant. Its health infrastructure was destroyed during the country’s decade-long civil war, and many families must travel long distances to reach health facilities. They are often too poor to pay for treatment and, all too frequently, must rely on traditional methods of care during childbirth.

© UNICEF/NYHQ2010-0700/Asselin
Patients queue to collect prescriptions from a hospital pharmacy in Freetown, the capital of Sierra Leone. In April 2010, the government launched a programme abolishing fees for health-care services for pregnant and lactating women and for children under five.

The result is that one in eight women in Sierra Leone dies from pregnancy-related complications. In industrialized countries, that risk is only 1 in 8,000.

Dr. Philip Koroma, the only gynaecologist in the southern part of Sierra Leone, serves an area comprising roughly 2.5 million people. While scanning a woman on her first visit recently, he could see that she was a week over term; he immediately admitted her for observation and a possible caesarean section.

"I have a lot of work, so I work every day, even on Sundays," he said.

Free health-care policy

Other negative health indicators, including poor nutrition and the widespread practice of female genital mutilation/cutting, also contribute to complications during pregnancy and childbirth.

© UNICEF/NYHQ2010-1039/Asselin
Sierra Leone's President Ernest Bai Koroma (right) greets a woman and her newborn at the Princess Christian Maternity Hospital in Freetown, the capital.

“One of the major causes of maternal death is bleeding,” said Sister Betty Patema, another health worker at Bo hospital. “You find many patients have anaemia from poor diet, so they bleed and need blood transfusion. If they do not get to the hospital in time, this can even lead to death.”

In response to this crisis, UNICEF is working with the Government of Sierra Leone and other partners – including the European Union, the World Bank and UK Aid – to introduce free health care for pregnant women, lactating mothers and children under the age of five. The policy abolishes fees for medical attention and provides drugs and treatments free of charge in every public health facility in the country.

Around 1.2 million mothers and children in Sierra Leone are expected to benefit from the new policy in 2010.

Massive demand

In line with the free health-care policy, Sierra Leone is also working to train a new generation of health-care professionals across the country. Today, however, health workers are still struggling to the meet massive demand for maternal care. As Ms. Barrie’s case shows, they do whatever they can to save mothers’ lives.

Back at Bo hospital, while Ms. Barrie recovered under the watchful eye of the nurses, her newborn son was taken for his first inoculations. A day later, she was through the worst of her eclampsia. It was clear that she would survive the complications of her pregnancy.

As Sierra Leone continues to push toward universal free care for its babies and new mothers, more women will have a better chance to live long and healthy lives.




UNICEF correspondent Nubia Lima reports on efforts to improve maternal health in Sierra Leone.
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