Sierra Leone continues to be one of the most dangerous places in the world to give birth – 1,360 mothers lose their lives in every 100,000 live births. This alarming figure compares poorly with Ireland where there are 5 deaths for every 100,000 births.
In, Kenema district, in the country’s south-east, GOAL teams are working to improve local services. The health facility in Sandaru serves approximately 3,000 people from five neighbouring communities. Nurses in the health centre are being provided with clinical mentoring to improve their capacity to respond to urgent complications which can occur while giving birth, such as haemorrhaging. This reduces the need to travel to Kenema regional hospital, over 2 hours away, and can be lifesaving if a pregnancy goes into difficulty.
Operational in Sierra Leone since 1999, GOAL has also been using innovative methods of building communities’ resilience and local capacity. Funded by Irish Aid, GOAL’s work also includes social behaviour change activities to help target a high rate of adolescent pregnancy.
Reducing Adolescent Pregnancy
With adolescent pregnancies reducing opportunities for mothers and increasing pregnancy risks, education is crucial. GOAL teams are holding ‘Community Dialogues’ with local youth people to discuss the impact and dangers of teenage pregnancies. Modern methods of contraception are also discussed with free access available in dedicated adolescent-friendly areas of local health centres – supported by GOAL.
In 2016, there were 90 adolescent pregnancies in the catchment area of Sandaru. This was reduced to 65 following GOAL interventions in 2017, and has dropped to 20 by 2020. In 2021, the number of adolescents attending antenatal visits was recorded at just 4. This demonstrates a positive trend in reduction of teenage pregnancies in the community.
Another initiative that has was launched following community feedback has been the blending of local Village Savings and Loan Association (VSLA) systems with community health initiatives. In Sandaru, a VSLA loan system was established to assist in supporting the cost of referrals for more serious health emergencies. This was not available previously, often leading to fatal consequences.
Mamaie was pregnant with twins in 2020, and credits the survival of herself and her twins’ safe delivery to the VSLA loan scheme. Mamaie was the first woman in the community to use the emergency loan and was admitted to Kenema regional hospital for one week, receiving treatment that saved her life.
“When I woke up after being treated, I asked my husband how we managed to pay for this,” says Mamaie. “He told me we loaned from the emergency fund.”
“On New Years Day, when I recovered, I was told I was being brought to the theatre but before they could I delivered in the ward. Sao the first-born twin was sick, and the emergency fund also allowed for his treatment in the hospital.”
“If not for these savings, my babies and I would not be here.” Her twins, Sao and Jina, are now two and a half years old and thriving.
Through improved healthcare delivery, reduced adolescent pregnancies and improved access to emergency funding, Sandaru and nearby communities are now able to access adequate healthcare.