Working with pastors and imams to share the good news about maternal and child health

BINKOLO, Sierra Leone - Charles Koroma is a healthy 16-month-old boy who lives with his parents and siblings in Binkolo, Bombali district, northern Sierra Leone. A major explanation for his good health, according to mum Isatu is the community church pastor, who has been trained to reinforce the information provided by the local health care workers at facility and community levels.

“He talked to us in church every week when I was pregnant and even after I had given birth,” she said. The key was not a miraculous gift of healing, but rather the counselling he gave on the importance of exclusive breastfeeding in the first six months, and getting her son immunized. “Charles loves to breastfeed and I let him do that whenever he wants to,” she said.

Numerous studies from around the world have shown that breastfed and vaccinated babies have fewer incidences of childhood illnesses, and less severe illnesses when they do fall sick. This is certainly evident in Charles’ case. According to Isatu, since Charles was born, he has been sick just once. “Our visits to the health facility in the past 16 months have mainly been to get his vaccines and check his weight and height,” she said.

Sierra Leone has one of the highest rates of maternal mortality and under-5 mortality in the world, with 1,360 deaths per 100,000 live births and 120 deaths per 1,000 live births respectively. In 2015 alone, 26,000 children aged under five died in Sierra Leone largely from common childhood illnesses and neonatal conditions like acute respiratory infections, congenital abnormalities and tetanus. Estimates from 2015 say that 1 in 17 mothers in Sierra Leone has a lifetime risk of death associated to childbirth.

The challenge, explains Andrew Sesay, community health officer at the Binkolo Health Centre, is that although the benefits of exclusive breastfeeding in the first six months, vaccinations, joining family planning schemes and handwashing are accepted in the medical community, these practices are still not as widespread as they should be. “It was difficult to convince the mothers to do what we tell them,” he said. But, he says the situation has improved since the religious leaders in his community started talking to people about basic health and hygiene issues. “Exclusive breastfeeding is now highly accepted and practiced by women, children are brought for vaccination and general hygiene practices have improved,” he added.

In West Africa, religious leaders are often the most respected figures in their communities. They have the power to raise awareness, shape social values, and influence attitudes, behaviours and practices. With funds from the Government of Japan, UNICEF has been supporting the Inter-Religious Council in Sierra Leone to work in communities across the country. Over the past two years, the organization has been working with close to 5,000 religious leaders through the Religions for Peace project, mobilizing communities and raising awareness about basic but crucial issues during prayer sessions and ceremonies, to stimulate positive behaviour change in the country’s population of which 77 percent is Muslim and 21 percent is Christian. All registered members of the organization have signed up to an agreement on not supporting child marriage. Defaulters are fined Le 100,000 (about USD 14) and reported for prosecution.

Rev. Daniel Sheka Mansaray is the Coordinator for the Inter-Religious Council in the northern region: “We are doing this because we want to promote good health and hygiene practices and education, and most importantly address maternal and child mortality,” he said. According to Rev. Mansaray, husbands are now increasingly supporting their wives before and after childbirth, ensuring their wives utilize health services, and even encouraging them to get enrolled in family planning services.

In a country with high maternal and child deaths, the efforts of the Inter-Religious Council in promoting good health practices in their communities will go a long way in improving maternal and child health and drastically reduce maternal and child deaths, which happens to be the main objective of the Saving Lives Programme implemented by UNICEF, WHO, and UNFPA, together with the Government of Sierra Leone, funded with UK aid from the British people.

Back at the health centre, health worker Andrew Sesay is also enthusiastic about the work of the religious leaders: “Families are practicing better hygiene and accessing health services more than before,” he said. “This is making our work easier and is crucial in reducing maternal and child morbidity and mortality in the country.”