Sierra Leone

About Sierra Leone

Sierra Leone has made great progress in lowering its rates of maternal and neonatal mortality, though recurring stresses to the health system like the 11-year civil war and 2014 Ebola outbreak have made long-term transformation difficult. A large portion of the country’s population faces increased threats to food security and livelihoods due to increasingly unpredictable rainy seasons exacerbated by climate change.

The majority of Sierra Leone’s population lives in rural areas, where access to basic health services can be extremely limited. As the health system continues to recover from the devastating 2014 Ebola outbreak, its health care workers face a severe lack of medicines, medical equipment, and trainings that can save lives.

The Challenges

High maternal and infant mortality

Sierra Leone’s health minister has called maternal and child health a “public health emergency” akin to Ebola or COVID-19. Though the country’s maternal mortality rates have greatly improved, Sierra Leone still has one of the highest rates in the world, with 443 deaths per 100,000 live births, a far cry from the Sustainable Development Goal target of less than 70. Sierra Leone’s goal is to reduce the rate to less than 300 by 2025.

Sierra Leone has cut its child mortality rates in half in the last two decades, but it still struggles with high infant mortality rates as well, with an under-5 mortality rate of 104 per 1,000 live births.

High mortality rates are due to multiple challenges, including a lack of medicines, medical supplies, transportation, and clean water, especially in rural communities. Most maternal and child deaths in Sierra Leone can be prevented if women are reached with the right information and skilled care.

A dire health worker shortage

The 2014-2016 Ebola outbreak killed a staggering 21% of the country’s entire health workforce, crippling an already fragile health system recovering from the country’s long civil war. The gap is still felt today, as the country continues to face a critical shortage of skilled health workers. Without an equipped health workforce, thousands of new and expecting mothers are at heightened risk of premature death, and so are their children.

Our History in Sierra Leone

Project HOPE’s work in Sierra Leone began during the 2014 Ebola epidemic, with a deployment of six infectious disease and disaster response and recovery experts to assess how to help combat the outbreak. During the response, Project HOPE’s assessment recognized the need for broader support to improve health outcomes for women, newborns, and children, which has become the primary focus of our ongoing work in the country today.

Our Work

Equipping Hospitals and Training Health Workers

Project HOPE provides training for health workers and equips clinic and hospital facilities to save the lives of mothers and newborns.

Health worker trainings include essential skills through courses like Helping Babies Breathe and Helping Mothers Survive, which equip midwives and nurses with essential lifesaving skills like infant resuscitation and management of postpartum hemorrhage. Project HOPE focuses on equipping lead trainers who then cascade their skills to other health workers across the country.

Promoting the adoption of Kangaroo Mother Care is an important part of this work. KMC is a low-cost warming technique for premature and low birthweight babies that involves wrapping the baby skin-to-skin with its mother. In contexts where incubators and other equipment is scarce, KMC can be a lifesaver for underweight newborns.

Project HOPE established the country’s first two KMC units at Ola During Children’s Hospital in Freetown and Bo District Hospital in Bo, which serve as centers of excellence for learning for other hospitals throughout Sierra Leone. We also support the renovation of neonatal care areas, and the creation of learning labs where health workers are able to continue their education.

>> Read More: In Sierra Leone, Health Workers Spark Long-Term Transformation

Launching Sierra Leone’s First-Ever Bachelor of Science and Master of Science Degrees

In partnership with Jefferson College of Nursing and the College of Medicine and Allied Health Science in Sierra Leone, Project HOPE established the country’s first-ever Bachelor of Science in Pediatric and Neonatal Nursing and Master of Science in Neonatal Nursing programs. Over two years, Project HOPE volunteer neonatal nurse educators developed curricula and trained faculty, including trips to Ola During Children’s Hospital in Freetown to focus on implementing the advanced curricula. The program includes the creation of two Project HOPE teaching fellows who instruct in the program. By April 2024, the program will have graduated more than 60 students across three cohorts.

>> Read more: How Project HOPE Volunteers Empowered a New Generation of Neonatal Nurses in Sierra Leone

Empowering mothers to manage their own health

Project HOPE’s footprint extends beyond hospital walls, into the communities where the mothers and children live. Through the facilitation of mother care support groups, we reach mothers with the knowledge they need to take care of themselves and their newborns in their own homes and communities. Each group consists of about 20 mothers and is led by a Project HOPE-trained “lead mother.”

These lead mothers play a critical role in connecting with women who are pregnant, building trust, and connecting them to clinics where they can receive prenatal care and deliver their children safely. These lead mothers then conduct follow-ups with new mothers to ensure they are exclusively breastfeeding their babies and receiving all needed vaccinations.

>> Read: Mother to Mother: Village Care Groups Save Lives in Sierra Leone