Sierra Leone continues to face significant challenges in the delivery of health services which has resulted in many mothers and babies dying from preventable causes. The Ebola outbreak further strained the already weak health system. However, there has been some success, despite the Ebola outbreak; more mothers, babies and young people now visit health services at private and public sector facilities compared to 2012. We played a vital role in improving access to health services through the Improving Reproductive, Maternal and Newborn Health (IRMNH) programme, which was implemented under the leadership of the Sierra Leone Ministry of Health and Sanitation (MoHS), with funding from UKAid. Recognising the success of the programme, external reviewers awarded it an ‘A+’ score signifying that the programme had exceeded expectations.
We worked in partnership with UNICEF, UNFPA and Marie Stopes Sierra Leone to increase the use of quality family planning, and reproductive, maternal and newborn health (RMNH) services with a specific focus on reaching young people. We used innovative approaches to increase awareness of the benefits of reproductive, maternal and newborn (RMNH) care, strengthen service delivery, and increase access to free RMNH services provided by private, faith based and non-governmental organisations. In recognition of the complexity of the programme, we provided the partnership management, evaluation and learning (PMEL) function which greatly improved information sharing and coordination across the implementing partners. In addition, we provided technical assistance to the MoHS which has strengthened their stewardship in improving healthcare for people in Sierra Leone. Decisions made by the Directorate of Reproductive and Child Health, and the Directorate of Policy Planning and Information in the Ministry are now based on high quality data and research. We conducted several studies and evaluations that have helped the Ministry to make informed policies and plans and guide implementation of current and future health interventions. Our support to the Ministry’s Health Management Information System (HMIS) resulted in better quality data, with data completeness increasing from 60% to 95%.
To ensure that future initiatives to improve health services will build on lessons and achievements of the IRMNH programme, a ‘lessons learned and dissemination’ meeting was held on 23rd May 2017 in Freetown. The meeting was chaired by Dr Santigie Sesay, Director of Reproductive and Child Health in the MoHS.
Participants at the meeting agreed that a focus on maintaining quality health data through training and supervision would continue. They also recognised the importance of continuing to provide supportive supervisory visits to assess the ability of facilities to provide emergency obstetric care. Efforts will be made to replicate project successes to ensure effective engagement of private health facilities.
It is essential that a focus on improving the coordination in the health supply chain to ensure that essential commodities are available at facilities is maintained and that skilled health workers need to be distributed effectively to make sure their skills are used properly. It was widely agreed that better coordination is needed to reach young people and educate them about sexual and reproductive health services.
The IRMNH programme made a significant difference in the lives of mothers, babies and young people. We encourage our partners and stakeholders to build on our efforts and lessons learned to reduce maternal and child mortality in Sierra Leone.