Equipping Sierra Leone’s health system for improved health service delivery
Making efforts to improve health service delivery
Gandorhun - It’s a sunny morning in Gandorhun town, a farming community in Moyamba District, southern Sierra Leone. Whilst most of the youthful residents head off to their farms, Nurse Agatha Tommy, the focal person for the Expanded Programme on Immunization (EPI) at the Gandorhun Community Health Centre (CHC), and her colleagues are visibly busy getting ready to attend to their clients for the morning – mothers and their babies. She heads to a solar refrigerator, stationed in the main waiting area, where she transfers a batch of vaccines from this unit into her vaccine carrier.
According to Nurse Agatha, this was not the case at the centre when she was initially posted there, and as recently as about two years ago. “Getting vaccines to administer on patients was a hassle,” she says, “Health workers at the centre had to travel about fifteen miles to the district cold store in Moyamba each week to collect vaccines and return the unused ones for re-storage,” she adds. The cost of collecting vaccines from the district cold store or the nearest health facility has been a burden on the health workers. However, with the procurement of additional cold chain equipment more health facilities are now able to effectively store vaccines and make it readily available to clients as they come. This has improved access and utilization of immunization services, including in hard-to-reach communities.
Sierra Leone has one of the highest rates of under-five mortality in the world with 94 deaths per 1,000 live births according to the 2017 Multiple Indicator Cluster Survey report. Tackling neonatal and child mortality in Sierra Leone, especially those that arise from preventable causes, and meeting the global target of reducing the neonatal mortality ratio to at least as low as 12 deaths per 1,000 live births and under-5 mortality to at least as low as 25 deaths per 1,000 live births, remains a key concern for the Government of Sierra Leone.
One of the key health strategies for reducing these deaths is vaccination programmes which has proven to be very effective over the years, helping to protect children from vaccine preventable diseases and other childhood illnesses, and helping to keep children alive and healthy. As part of this effort, UNICEF is working in partnership with the Government to strengthen the country’s health system to improve health service delivery, including the provision of vaccines, ancillary materials and cold chain equipment.
With funding from United States Agency for International Development (USAID), UNICEF has supported the Government of Sierra Leone with the procurement and installation of 95 sets of solar fridges in health facilities across the country. In addition, 32 Cold Chain Technicians have been trained on equipment installation, repairs and basic preventive maintenance, and equipped with installation and maintenance toolkits.
“We remain committed to working hard to reduce the number of children dying in Sierra Leone due to preventable causes,” says Baboucarr Boye, Immunization Specialist at UNICEF Sierra Leone. “This recent investment in solar equipment and capacity enhancement will directly help improve immunisation service delivery in the country, especially for children under the age of five.”
The Gandorhun CHC which provides about 5,753 people from 32 communities with basic health services is one of the health centres that benefitted from this support. “Thanks to the availability of a solar refrigerator at the centre, other health workers and I are able to easily access and administer vaccines in their potent state,” says Nurse Agatha. In 2022, about 1,272 doses of various vaccines were administered at the centre.
Josephine Kamara, a resident of Gandorhun who has brought in her two-month-old daughter Jeneba Karim to get vaccinated shares the feeling of gratitude. “I am happy and thankful that my child is getting her vaccines on time,” she says. “That was not the case for other mothers as they had to wait for a certain time when the nurses were able to travel to Moyamba to get vaccines,” she adds.
Apart from the in-facility immunisation sessions held at the CHC, the availability of the solar refrigerator makes it possible for nurse Agatha and her colleagues to embark on outreach sessions in neighboring villages on designated days.
“The outreach sessions give us an extra opportunity to educate parents about the importance of vaccinating their children,” says Nurse Agatha. “We endeavor to go the extra mile to ensure that we reach out to children who have missed taking one or more of the vaccines because we want every child to survive.”
As the day’s immunisation session comes to an end, Nurse Agatha is optimistic that the support that has gone into improving immunization services will go a long way in the country’s fight to reduce its child morbidity and mortality to the barest minimum.