Helping Sierra Leone’s newborns survive and grow

A joint programme aims to increase access and use of health services to ensure all children get the best start in life

By Harriet Mason
Three-week-old baby Kamara on life support in the neonatal ward
UNICEF Sierra Leone/2016/Mason
21 February 2017

KENEMA, Sierra Leone, 21 February 2017 – It’s early morning and health workers and the relatives of patients admitted to the Kenema Government Hospital are making their way in and out of the hospital compound.

In the neonatal ward, three-week-old-baby Kamara is starting his third day on life support, receiving treatment for bladder and bowel malfunction.

He was rushed to the hospital after his mother Haja Kamara noticed his poor health about a week after he was born. “We were admitted as soon as we arrived. The nurses were really nice. They comforted me and gave my son all the attention they could,” says Haja.

But sometimes the neonatal ward – one of the busiest in the hospital – gets overwhelmed because of a lack of medical staff and inadequate equipment and supplies.

“When it gets very busy, we have no option but to ask patients to share beds or move to the antenatal section to make space for others,” says Sister Margaret Fatoma, Staff Midwife in charge of the maternal and neonatal unit at the hospital.

The huge influx of patients with maternal and neonatal issues is partly because the equipment needed for treatment, including life support machines, is only available in district and regional hospitals. In 2016 alone, the unit admitted around 2,000 women with pregnancy related issues and delivered more than 1,300 babies. Sadly 43 of these babies died within their first month.

Sierra Leone has one of the highest rates of neonatal and under-five mortality in the world, with 35 deaths per 1,000 live births and 120 deaths per 1,000 live births respectively. In 2015 alone, 26,000 children under the age of 5 died, largely from common childhood illnesses and neonatal conditions like acute respiratory infections, congenital abnormalities, tetanus, sepsis, and birth asphyxia.

>> Learn more: Maternal and Newborn Health Disparities Sierra Leone

Sister Margaret checks the blood pressure of pregnant woman.
UNICEF Sierra Leone/2016/Mason
Sister Margaret checks the blood pressure of nine-month-pregnant Fatmata Yonnie in the maternity ward at the Kenema Government Hospital. The Saving Lives Programme aims to reduce maternal and child deaths in Sierra Leone.

As part of the Sustainable Development Goals, world leaders have committed by 2030 to reduce neonatal mortality to at least 12 per 1,000 live births, with under-five mortality reduced to at least 25 per 1,000 live births. To achieve this target in Sierra Leone, a large number of pregnant women will need to have equitable access to high quality care by skilled personnel during pregnancy and childbirth. Newborns will also need improved care, particularly during the delicate first 24 hours immediately after birth, and the following 28 days of life.

Improving maternal and child health in Sierra Leone is a key concern for the Ministry of Health and Sanitation, supported by UNICEF, the World Health Organization (WHO) and other partners. “We have been working with the government to tackle maternal and child deaths through investment in the training of health workers and provision of equipment and medical supplies,” says Dr. Nuzhat Rafique, Health Manager at UNICEF Sierra Leone.

Building on previous efforts, UNICEF, WHO, and the United Nations Population Fund will work together with the Ministry of Health and Sanitation to accelerate the reduction of maternal, newborn, child and adolescent mortality and morbidity. The initiative is in support of the President's Recovery Priorities (PRP), which aims to save the lives of 600 women and 5,000 children by 2018. “Through this Saving Lives Programme, funded with UK aid from the British People, we aim to work relentlessly to improve the country’s maternal and child health system and drastically reduce maternal and child deaths in Sierra Leone,” she adds.

By March 2021, this programme aims to increase the use of health services across the country. This includes efforts to ensure that 62 per cent of deliveries are done in health facilities, 62 per cent of newborns receive a first postnatal care check-up in the first 48 hours after delivery in facilities, 80 per cent of children under 5 with confirmed malaria are correctly treated according to national guidelines, and 300,000 new people engage in family planning.

In the first phase of the programme, partners will work on improving several important areas of health service delivery. According to Dr. Nuzhat, nine emergency obstetric newborn care (EmONC) facilities and 100 adolescent friendly health facilities will be upgraded; three newborn intensive care units will be established at regional hospitals; one at Ola During Hospital in Freetown; and three midwifery schools will be set up.

In a country where the majority of people still live on less than US$1.25 a day, access to quality free or affordable health services is treasured by mothers like Haja. “We are really grateful for all the health interventions that have been brought to help reduce maternal and child deaths in our country. If not for the free health services, my child could not still be alive, because we can’t afford paying for his treatment,” she says.

Back in the maternity ward Sister Margaret is already visibly excited about what the Saving Lives Programme will offer as she checks on her patients. “I am really looking forward to the additional support this programme will bring to the women and children of Sierra Leone because I believe that will help make our work easier and more fruitful,” she said with a smile.

>> Learn more: Join the fight to save children's lives